Diagnosis of Barrett's esophagus and esophageal neoplasia: East meets West

Barrett's esophagus has traditionally been considered to be a predominantly 'Western world' neoplastic condition. However, over the years, Asian countries are beginning to diagnose increasing numbers of patients with gastroesophageal reflux disease, columnar metaplasia at the gastroesophageal junction, Barrett's esophagus, and esophageal adenocarcinoma. Hence, the controversies regarding screening for and surveillance of Barrett's esophagus and esophageal adenocarcinoma have become more widely relevant to gastroenterologists around the world. Emerging concepts related to esophageal cancer prevention and early detection include the screening for Barrett's esophagus using wireless videocapsule endoscopy, and chromoendoscopy, enhanced high resolution endoscopy. There is also interest in improving surveillance for esophageal neoplasia using novel imaging techniques, such as high resolution and high magnification endoscopy, narrow-band imaging, autofluorescence imaging, and endocytoscopy/endomicroscopy. The enhanced detection of Barrett's esophagus and esophageal neoplasia become even more clinically relevant because of accumulating data on the safety and effectiveness of mucosal ablative techniques (such as photodynamic therapy, argon plasma coagulation, low pressure cryotherapy) and endoscopic mucosal resection. This article summarizes the latest developments related to Barrett's esophagus that are of interest to endoscopists from the East or West.