Prior endoscopic surveillance and diagnosis of Barrett-related dysplasia and cancer: evidence from a nationwide Dutch cohort.

Ninety percent of patients with Barrett-related dysplasia and cancer were diagnosed without prior endoscopic surveillance, highlighting gaps in early detection.

• Why it matters: Early detection of dysplasia and esophageal adenocarcinoma (EAC) is crucial for improving patient outcomes, yet many cases are diagnosed de novo, indicating missed opportunities for screening.
• What they did: The study analyzed 8,914 patients in the Netherlands from 2008 to 2018, examining endoscopy histories and the contribution of surveillance to diagnosis, with at least one prior endoscopy in 10% of cases.
• The result: Findings show that 65% of patients undergoing endoscopic treatment had no prior endoscopy, and only 11% of those with previous surveillance missed advanced neoplasia, emphasizing the need for targeted screening strategies.