What Your Health Care Provider is Reading: Expert Panel Does Not Recommend Screening for Barrett's Esophagus for Adults Over Age
A critical review of the diagnosis and management of Barrett's esophagus: the AGA Chicago Workshop
July 2004 (Gastroenterology 2004;127:310-330) - Barrett's esophagus represents a change in the cells lining the end of the esophagus that is believed to be caused by acid reflux. Because patients with Barrett's can sometimes develop cancer, some experts have recommended endoscopic screening to detect Barrett's in individuals over age 50 or those with longstanding heartburn. A recently published report from an expert panel challenges those recommendations.
The Chicago Workshop assembled 18 physicians (15 gastroenterologists, 2 surgeons, 1 pathologist) from 4 countries. All the participants had an established basic or clinical research interest in Barrett's esophagus. Members of the workshop were unanimous in rejecting the statement "routine endoscopic screening for the detection of Barrett's esophagus should be recommended for all adults 50 years and older." Furthermore, the majority of experts rejected the recommendation to screen adults 50 years and older with heartburn for more than 5-10 years. The experts noted that "current evidence does not support endoscopic screening for Barrett's in all adults 50 years of age and older with heartburn." The panel felt that there could be potentially unintended harms of screening such as anxiety, unnecessary follow-up examinations, and difficulty obtaining life and other insurance.
If you suffer from heartburn, you should understand that your risk of developing Barrett's esophagus and cancer of the esophagus is very low. There are very effective medications that can treat heartburn symptoms. But, if you have questions about your heartburn symptoms, your risk of developing complications or your current treatment, ask your doctor.
