Surveillance guidelines for Barrett esophagusa
| Nondysplastic Barrett esophagus |
| AGA, ACG, and ASGE recommend surveillance every 3–5 years |
| ‘Indefinite for dysplasia’ |
| AGA: no recommendation |
| ACG: repeat esophagogastroduodenoscopy (EGD) after 3–6 months of proton pump inhibitor (PPI) therapy; if repeat EGD indicates “indefinite for dysplasia,” then surveillance every 12 months |
| ASGE: additional pathology review, PPI dose escalation, and repeat |
| EGD with biopsy |
| Low-grade dysplasia |
| AGA: surveillance every 6–12 months |
| ACG: either endoscopic eradication therapy for confirmed low-grade dysplasia for patients without a life-limiting comorbidity, or surveillance every 12 months |
| ASGE: repeat EGD in 6 months to confirm low-grade dysplasia, then surveillance every year, with eradication therapy in select patients |
| High-grade dysplasia |
| AGA: eradication therapy or surveillance every 3 months |
| ACG: eradication therapy for confirmed high-grade dysplasia in patients without a life-limiting comorbidity |
| ASGE: eradication therapy or surveillance every 3 months |
↵a All guidelines recommend confirmation of dysplasia by an expert gastrointestinal pathologist.
ACG = American College of Gastroenterology4; AGA = American Gastroenterological Association24; ASGE = American Society for Gastrointestinal Endoscopy23