Diagnosis and management of Barrett's oesophagus

#### Summary points Barrett’s oesophagus affects 2% of the adult population in the West, which makes it one of the most common premalignant lesions after colorectal polyps. Conversion to oesophageal adenocarcinoma is the most important complication of the condition, with a lifetime risk of 5% in men and 3% in women.1 2 3 4 Several large trials investigating surveillance (Barrett’s Oesophagus Surveillance Study (BOSS)), chemoprevention (the Aspirin Esomeprazole Chemoprevention Trial (AspECT)), genetic stratification (EArly Genetics and Lifecourse Epidemiology (EAGLE) consortium), and endotherapy for high risk individuals are under way to determine the best way to prevent progression to adenocarcinoma. There are now several endoscopic alternatives to the long established technique of radical surgical oesophagectomy for treating high grade dysplasia and early mucosal cancer, which avoid the mortality and morbidity of surgery. Recently consensus on optimal management of the condition was reached after a National Institute of Health and Clinical Excellence (NICE) review. It …