1. AGA suggests that endoscopic surveillance be performed in patients with Barrett’s esophagus with the following surveillance intervals:
a. No dysplasia: 3-5 years
b. Low-grade dysplasia: 6-12 months
c. High-grade dysplasia in the absence of eradication therapy: 3 months
2. AGA suggests against the use of molecular biomarkers to confirm the histologic diagnosis of dysplasia or as a method of risk stratification for patients with Barrett’s esophagus at this time.
3. For patients with Barrett’s esophagus who are undergoing surveillance, AGA recommends endoscopic evaluation be performed using white light endoscopy.
4. For patients with Barrett’s esophagus who are undergoing surveillance, AGA recommends 4-quadrant biopsy specimens be taken every 2 cm.
5. For patients with Barrett’s esophagus who are undergoing surveillance, AGA recommends specific biopsy specimens of any mucosal irregularities be submitted separately to the pathologist.
6. For patients with Barrett’s esophagus who are undergoing surveillance, AGA recommends 4-quadrant biopsy specimens be obtained every 1 cm in patients with known or suspected dysplasia.
7. AGA suggests against requiring chromoendoscopy or advanced imaging techniques for the routine surveillance of patients with Barrett’s esophagus at this time.
8. AGA recommends against attempts to eliminate esophageal acid exposure (proton pump inhibitors [PPIs] in doses greater than once daily, esophageal pH monitoring to titrate PPI dosing, or antireflux surgery) for the prevention of esophageal adenocarcinoma.
9. AGA recommends screening patients to identify cardiovascular risk factors for which aspirin therapy is indicated.
10. AGA suggests against the use of aspirin solely to prevent esophageal adenocarcinoma in the absence of other indications.
11. AGA recommends endoscopic eradication therapy with radiofrequency ablation (RFA), photodynamic therapy (PDT), or endoscopic mucosal resection (EMR) rather than surveillance for treatment of patients with confirmed high-grade dysplasia within Barrett’s esophagus.
12. AGA recommends EMR for patients who have dysplasia in Barrett’s esophagus associated with a visible mucosal irregularity to determine the T stage of the neoplasia.
