Acetic acid chromoendoscopy for detection of neoplastic Barrett's oesophagus: stepped wedge cluster randomised controlled trial (ACID-trial).

Acetic acid chromoendoscopy does not increase neoplasia detection rates in Barrett's oesophagus surveillance endoscopies, with a 7.2% overall neoplasia diagnosis rate.

• Why it matters: Detecting dysplasia and oesophageal adenocarcinoma early is crucial for patient outcomes, but current methods may miss lesions, highlighting the need to evaluate new techniques like AAC.
• What they did: A stepped wedge cluster randomized trial involving 2267 patients across 18 Dutch hospitals compared surveillance with and without AAC, measuring neoplasia detection rates and targeted biopsy outcomes.
• The result: AAC application did not significantly alter the neoplasia detection rate (7.4% with AAC vs. 7.1% without; OR 0.97), though it increased suspected lesion detection, but without improving targeted neoplasia detection.