Barrett’s esophagus (BE) is currently a field in rapid evolution. A number of well established paradigms have been recently challenged with new insights being gained in several areas, such as pathogenesis, screening, and therapy. In this issue of Gastroenterology Clinics of North America , we attempt to succinctly summarize and describe challenges being posed to these long-established dogmas by intriguing new data. We also outline new developments that have the potential of greatly expanding our understanding of the pathogenesis, early detection, risk stratification, and treatment of subjects with BE with and without dysplasia/neoplasia.
In this issue, we have brought together established and emerging thought leaders in the field to elucidate this new information. Our topics range from pathogenesis and epidemiology of BE, the strong relationship between obesity and BE, new developments in the early detection of BE to risk stratification with biomarkers, novel advanced imaging techniques and therapy of dysplasia, and neoplasia in BE, including both endoscopy and surgery. Despite impressive advances in the therapeutic armamentarium of BE-related dysplasia, several challenges continue to exist and emerge, which are outlined in a separate article. We also focus on summarizing the current status of chemoprevention, cost effectiveness of current therapeutic approaches in BE, with a final summary of emerging molecular technology (such as genomics), which has the potential of providing insights into hitherto unexplored areas in BE, such as markers to assess cancer risk and progression in BE.
We hope that this issue of Gastroenterology Clinics of North America will prove a valuable and indispensable resource to gastroenterologists who have a clinical and research interest in BE. In addition, we also have outlined the research agenda for the next decade in this exciting field, which we hope will enable reducing the incidence and mortality of esophageal adenocarcinoma.