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Monitoring the premalignant potential of Barrett's oesophagus'
  1. David Graham1,2,
  2. Gideon Lipman1,2,
  3. Vinay Sehgal1,2,
  4. Laurence B Lovat1,2
  1. 1Division of Surgery and Interventional Science, University College London, London, UK
  2. 2Gastrointestinal Unit, University College Hospital, London, UK
  1. Correspondence to Dr Laurence B Lovat, Division of Surgery & Interventional Science, UCL, Wing 2.4 Cruciform Building, Gower Street, London WC1E 6BT, UK; l.lovat{at}


The landscape for patients with Barrett's oesophagus (BE) has changed significantly in the last decade. Research and new guidelines have helped gastroenterologists to better identify those patients with BE who are particularly at risk of developing oesophageal adenocarcinoma. In parallel, developments in endoscopic image enhancement technology and optical biopsy techniques have improved our ability to detect high-risk lesions. Once these lesions have been identified, the improvements in minimally invasive endoscopic therapies has meant that these patients can potentially be cured of early cancer and high-risk dysplastic lesions without the need for surgery, which still has a significant morbidity and mortality. The importance of reaching an accurate diagnosis of BE remains of paramount importance. More work is needed, however. The vast majority of those undergoing surveillance for their BE do not progress towards cancer and thus undergo a regular invasive procedure, which may impact on their psychological and physical well-being while incurring significant cost to the health service. New work that explores cheaper endoscopic or non-invasive ways to identify the at-risk individual provides exciting avenues for research. In future, the diagnosis and monitoring of patients with BE could move away from hospitals and into primary care.


This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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