A Practical Guide to Incorporating Novel Barrett’s Screening/Surveillance Tools into Clinical Practice

Barrett’s esophagus (BE) is the only known precursor for esophageal adenocarcinoma. Patients diagnosed in endoscopy-based screening and surveillance programs have improved outcomes, but there are many limitations with current screening and surveillance paradigms. This review examines novel technologies aimed at improving current BE screening and surveillance strategies. BE risk stratification algorithms have decent discriminatory performance but are cumbersome to implement. Non-endoscopic screening tools, including swallowable cell collection devices, have shown good sensitivity and cost-effectiveness. Early studies of serum biomarkers, such as microRNA assays, have yielded promising results but warrant further validation. WATS-3D appears to increase dysplasia yield among patients undergoing surveillance. Tissue-based biomarkers may assist in risk stratification. Novel, non-endoscopic technologies have the potential to enrich the BE screening population and improve outcomes, although most require further validation. Collaboration with primary care providers is critical to maximize the impact of such interventions.