Barrett's metaplasia: Defining the problem

Concern over how best to manage individuals with Barrett's esophagus (BE) has grown because of the consistent rise in the incidence of esophageal adenocarcinoma. Since the 1970s, the rate of increase in incidence of esophageal adenocarcinoma has been greater than that for any other cancer in the US population. Patients with BE have increased risk for esophageal cancer, but the rate of progression and potential risk factors in progression remain poorly understood. Much remains to be learned about BE and its association with adenocarcinoma before effective surveillance or management strategies can be defined and implemented. In this article, the relationship between BE and gastroesophageal reflux disease, risk for adenocarcinoma, and prospects for molecular diagnosis are discussed.