Barrett's oesophagus
A change in the lining of the lower oesophagus caused by acid reflux that can, in a minority, progress through dysplasia to adenocarcinoma. It is why Western oesophageal cancer is mostly adenocarcinoma.
Intestinal metaplasia of the distal oesophagus in ~1-2% of adults; annual progression to adenocarcinoma ~0.1-0.3%, higher with dysplasia. Surveillance endoscopy, radiofrequency ablation and endoscopic resection for dysplasia, and proton-pump inhibitors (AspECT) reduce progression. Non-endoscopic screening (Cytosponge, capsule sponge) is being evaluated for population use.
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