Esophageal Adenocarcinoma: Screening, Surveillance, and Management

Annu Rev Med. 2017 Jan 14:68:213-227. doi: 10.1146/annurev-med-050715-104218. Epub 2016 Aug 31.


Esophageal adenocarcinoma (EAC) is a growing problem with a rapidly rising incidence. Risk factors include gastroesophageal reflux disease, central obesity, and smoking. The prognosis of EAC remains poor because it is usually diagnosed late, and many efforts have been made to improve prevention, early detection, and treatment. Acid suppression, nonsteroidal antiinflammatory drugs (NSAIDs), and statins may play a role in chemoprevention. Screening for Barrett's esophagus (BE), the only known precursor lesion of EAC, is indicated for individuals with increased risk. Endoscopic surveillance of patients with BE likely improves overall outcomes. Endoscopic ablation and resection is highly effective for treating dysplastic BE and early EAC, whereas esophagectomy is indicated for patients with locally advanced disease. This review covers epidemiology, staging, screening, and prevention of EAC as well as endoscopic and surgical management.

Keywords: Barrett's esophagus; advanced endoscopic imaging; chemoprevention; endoscopic eradication therapy; screening; surveillance.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / secondary
  • Adenocarcinoma / therapy*
  • Barrett Esophagus / diagnosis*
  • Barrett Esophagus / diagnostic imaging
  • Barrett Esophagus / therapy*
  • Catheter Ablation
  • Chemoprevention
  • Early Detection of Cancer
  • Endoscopic Mucosal Resection
  • Esophageal Neoplasms / diagnosis*
  • Esophageal Neoplasms / epidemiology
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / therapy*
  • Esophagectomy
  • Esophagoscopy / methods
  • Humans
  • Microscopy, Confocal
  • Neoplasm Staging
  • Population Surveillance*
  • Risk Factors