Barrett's esophagus screening: Current modalities, risk-based approaches, and future perspectives

Barrett's Esophagus (BE) is a precursor lesion of esophageal adenocarcinoma (EAC). To enable early detection of neoplasia, BE patients undergo regular endoscopic surveillance. However, more than 90 % of EAC patients were not previously diagnosed with the precursor BE, indicating that detection practices are inadequate. Screening for BE could be a strategy to detect BE in the general population, bridging the gap in early diagnosis. Given the limitations of affordable and accessible endoscopy methods for widespread use, efforts should prioritize targeted screening of at-risk individuals using less invasive approaches. For instance, the use of cell collection devices coupled with biomarker assays in patients with GERD could offer a more cost-effective solution to identify undiagnosed cases. In this review, we provide a comprehensive overview of the at-risk population for BE, current screening modalities, and future perspectives to pave the way for effective and practical BE screening.