Dysplasia and Cancer Screening
Periodic endoscopic examinations to look for early warning signs of cancer are generally recommended for people who have Barrett's esophagus. This approach is called surveillance. When people who have Barrett's esophagus develop cancer, the process seems to go through an intermediate stage in which pre-cancerous cells appear in the Barrett's tissue. This condition is called dysplasia and can be seen only in biopsies of tissue examined under a microscope. The process is patchy and cannot be seen directly through the endoscope, so multiple biopsies must be taken. Even then, cancer cells can be missed.
The process of change from Barrett's to cancer seems to happen in only a few patients, less than 1 percent per year, and over a relatively long period of time. Most physicians recommend that patients with Barrett's esophagus undergo periodic surveillance endoscopy to have biopsies. The recommended interval between endoscopies varies depending on specific circumstances, and the ideal interval has not been determined.
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