[Surveillance for Barrett's oesophagus: worthwhile?].

Patients with Barrett's oesophagus have an increased risk of developing oesophageal adenocarcinoma; surveillance is therefore recommended for these patients. However, it has never been proven that Barrett surveillance is actually effective. A recent article in The American Journal of Gastroenterology shows that patients with Barrett's oesophagus with high-grade dysplasia had a lower risk of developing oesophageal adenocarcinoma when they had previous surveillance or endoscopic therapy. These results suggest that surveillance may improve survival of patients with Barrett's oesophagus. However, there is no convincing evidence that surveillance has an effect on mortality due to oesophageal adenocarcinoma. Although the absolute overall risk of developing oesophageal adenocarcinoma in Barrett's oesophagus is low, surveillance is important in the small group of patients with a high risk of neoplastic progression.