ArticleGastrointestinal endoscopy2021
Prevalence of Barrett's esophagus and performance of societal screening guidelines in an unreferred primary care population of U.S. veterans.
Article in Gastrointestinal endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07335445 (Enhancing Screening Practices for Barrett's Esophagus), which is not on this map. Cited by 25 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Enhancing Screening Practices for Barrett's Esophagus
Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Risk Factors for the Development of Barrett's Esophagus and Esophageal Adenocarcinoma: A Systematic Review and Meta-Analysis.Cancer reports (Hoboken, N.J.) · 2025Pooled it
- Prevalence of Barrett's Esophagus and Esophageal Adenocarcinoma With and Without Gastroesophageal Reflux: A Systematic Review and Meta-analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Pooled it
- AGA Clinical Practice Update on New Technology and Innovation for Surveillance and Screening in Barrett's Esophagus: Expert Review.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Guideline
- Screening for Barrett's esophagus and esophageal adenocarcinoma: recent advances and next steps.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Review
- A Practical Guide to Incorporating Novel Barrett's Screening/Surveillance Tools into Clinical Practice.Current gastroenterology reports · 2026Review
- Liquid Biopsy and Nonendoscopic Biomarkers for Precision Early Detection of Esophageal Cancer: Evidence, Risk Stratification and Translational Challenges.Journal of Cancer · 2026Review
- Nonendoscopic Screening for Barrett's Esophagus: Current Methods, Evidence, and Future Directions.Gastro hep advances · 2026Review
- Leveraging Natural Language Processing to Accurately Identify Histologically Confirmed Esophageal and Gastric Premalignant and Malignant Conditions Using a Large-Scale Health-Record Linked Genomic Biobank.Gastro hep advances · 2026Article
- AI-Driven Risk Prediction Tool (TSP-9) Informs Risk-Aligned Care for Patients with Barrett's Esophagus.Diagnostics (Basel, Switzerland) · 2025Article
- New Approaches to Screening for Barrett Esophagus.Gastroenterology & hepatology · 2025Article
- Cost-effective identification of Barrett's esophagus in the community: A first step towards screening.Journal of gastroenterology and hepatology · 2024Article
- Barrett's Esophagus Risk Factors in Patients Without Gastroesophageal Reflux: A Large Population-Based Study.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Article
- Prospect and Challenges of Volatile Organic Compound Breath Testing in Non-Cancer Gastrointestinal Disorders.Biomedicines · 2024Review
- Esophageal cancer screening, early detection and treatment: Current insights and future directions.World journal of gastrointestinal oncology · 2024Review
- Advances in Screening for Barrett Esophagus and Esophageal Adenocarcinoma.Mayo Clinic proceedings · 2024Review
- Missed Opportunities: the Timing and Frequency of Screening Colonoscopy in Patients That Develop Esophageal Adenocarcinoma.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- New Techniques to Screen for Barrett Esophagus.Gastroenterology & hepatology · 2023Article
- Estimated Burden of Screening for Barrett's Esophagus in the United States.Gastroenterology · 2023Article
- Diagnosis and Management of Barrett's Esophagus.Journal of clinical medicine · 2023Review
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4 authors.
Funding
Abstract
BACKGROUND AND
aimsLess than 10% of patients diagnosed with esophageal adenocarcinoma have a pre-existing Barrett's esophagus (BE) diagnosis, possibly because of suboptimal performance of guidelines. We examined the prevalence of BE in a previously unscreened primary care population and the potential yield of practice BE screening guidelines.
methodsThis was a retrospective analysis of a prospective cross-sectional study of consecutively recruited unreferred patients from primary care clinics who underwent study upper endoscopy. We examined the performance of BE screening guidelines of the European Society of Gastrointestinal Endoscopy (ESGE), British Society of Gastroenterology (BSG), American Society for Gastrointestinal Endoscopy (ASGE), American College of Gastroenterology (ACG), American Gastroenterological Association (AGA), and our own modification of guidelines.
resultsWe identified 44 BE cases and 469 control subjects (prevalence, 8.6%). Among 371 patients without GERD symptoms, 25 (6.7%) had BE. The AGA guidelines requiring ≥2 BE risk factors had sensitivity of 100% and specificity of only .2%, whereas ACG, ASGE, ESGE, and BSG guidelines (all requiring GERD first) had low sensitivities (38.6%-43.2%), specificities ranging from 67.4% to 76.5%, and area under the receiver operating curve (AUROC) of .50 to .60. Our 2-pronged approach depending on presence or absence of GERD symptoms but with other risk factors achieved sensitivity of 81.8%, specificity of 51.2%, and AUROC of .66.
conclusionsOver half of BE cases were without frequent GERD symptoms, but virtually all had at least 1 known BE risk factor. Practice guidelines requiring GERD symptoms have low sensitivity, whereas those not requiring GERD have low specificity. We have proposed a screening guideline with better use of known risk factors.
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