Should We Ablate Nondysplastic Barrett Esophagus?

In an opinion paper, experts disputed the reasons for using endoscopic ablation to reduce risk for cancer.

Patients with nondysplastic Barrett esophagus are typically treated with antireflux therapy. However, these therapies can fail to reverse the premalignant epithelium. Some patients with nondysplastic BE will progress to esophageal adenocarcinoma (EAC), so enrollment in a surveillance program is recommended. Endoscopic ablation therapy has been suggested as a means of ameliorating both the risk for cancer and the need for surveillance in this setting. In a recent opinion paper, five leading experts on BE disagreed with this approach and took issue with the rationales typically given for using endoscopic ablation as a preventive therapy.

Ablation should lower risk for developing EAC. The lifetime cancer risk for patients with nondysplastic BE…

Reviewing Author

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors

David A. Johnson, MD

Disclosures

Consultant/Advisory boardMedscape/WebMD; Pfizer; CRH Medical Corporation; Aries

EquityCRH Medical Corporation

Editorial boardsMedscape Gastroenterology

Leadership positions in professional societiesAmerican College of Gastroenterology Research Institute Board of Directors