Screening for Barrett’s Esophagus and Esophageal Adenocarcinoma: Rationale, Recent Progress, Challenges, and Future Directions Sarmed S. Sami, Krish.

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Screening for Barrett’s Esophagus and Esophageal Adenocarcinoma: Rationale, Recent Progress, Challenges, and Future Directions Sarmed S. Sami, Krish Ragunath, Prasad G. Iyer Clinical Gastroenterology and Hepatology Volume 13, Issue 4, Pages 623-634 (April 2015) DOI: 10.1016/j.cgh.2014.03.036 Copyright © 2015 AGA Institute Terms and Conditions

Figure 1 Tools currently undergoing evaluation for use in BE screening. (A) Cytosponge (Cambridge University); (B) EG scan system (Intromedic, Ltd, Seoul, South Korea) (disconnected); (C) EG scan system (connected); and (D) EndoSheath system (Vision-Sciences, Inc, Orangeburg, NY). Clinical Gastroenterology and Hepatology 2015 13, 623-634DOI: (10.1016/j.cgh.2014.03.036) Copyright © 2015 AGA Institute Terms and Conditions

Figure 2 (A) Estimated incidence of EAC in populations with weekly GERD symptoms. Incidences of colorectal cancer (CRC) and breast cancer (BrCa) are displayed for context. The benchmark incidence of cancer for endorsed screening is shown by the green horizontal line. Thick lines represent EAC, thin lines represent CRC, and dotted lines represent BrCa. Thin dashed lines represent the upper and lower confidence limits of the incidence of EAC in men with weekly GERD, and the upper confidence limit of EAC in women with weekly GERD. The lower confidence limit for women with GERD overlaps the point estimate incidence of EAC in women and is not visible on the figure. (B) Estimated incidence of EAC in populations with daily GERD symptoms. Reprinted by permission from Macmillan Publishers Ltd: The American Journal of Gastroenterology, copyright 2011.56 Clinical Gastroenterology and Hepatology 2015 13, 623-634DOI: (10.1016/j.cgh.2014.03.036) Copyright © 2015 AGA Institute Terms and Conditions

Figure 3 Proposed future approach to reducing mortality from EAC by using screening and targeted surveillance coupled with endotherapy. LSBE, long-segment BE; M-BERET, Michigan Barrett’s Esophagus pREdiction Tool. Clinical Gastroenterology and Hepatology 2015 13, 623-634DOI: (10.1016/j.cgh.2014.03.036) Copyright © 2015 AGA Institute Terms and Conditions