NYU Langone doctors recommend that people with Barrett’s esophagus consider getting screened for esophageal cancer. In Barrett’s esophagus, healthy squamous cells in the lower esophagus become damaged and, over time, are replaced by glandular cells that are better able to stand up to the acid. People with this condition are at higher risk for developing esophageal cancer.
Barrett’s esophagus is a possible complication of gastroesophageal reflux disease, or GERD, in which acidic stomach contents frequently rise into the esophagus. Although there are no recommended guidelines for screening people with GERD for esophageal cancer, our doctors may monitor you if you have Barrett’s esophagus.
When developing a screening plan, our doctors may take into account other risk factors. These may include a family history of the condition, smoking, heavy alcohol use, and poor nutrition, which includes a diet low in fruits, vegetables, and whole grains. Being overweight or obese is also a risk factor, as is being infected with the human papillomavirus, or HPV.
Another risk factor for esophageal cancer is achalasia, a disorder in which the muscles in the lower esophagus and the valve between the esophagus and stomach stop working properly, causing food to sit in the esophagus for long periods. Previous surgery, rare genetic disorders, or damage from head and neck radiation therapy—the use of high-energy beams to treat cancer—may also raise your risk.
If you’re at high risk for developing esophageal cancer, our doctors can talk to you about regular screening. They may perform tests every six months to a year, depending on your risk factors.
Upper Endoscopy with Biopsy
To screen for esophageal cancer, doctors perform an upper endoscopy to inspect the lining of the esophagus and the junction where the esophagus meets the stomach, where cancers related to Barrett’s esophagus typically start.
During the procedure, doctors use an endoscope, a thin, lighted tube with a camera on the end, which they insert through the nose or mouth into the esophagus. The endoscope is then guided through the stomach into the first part of the intestine. This procedure requires sedation to help you relax.
If the lining of the esophagus appears abnormal, the doctor can also perform a biopsy, in which he or she inserts small surgical tools through the endoscope to remove tissue to check for signs of cancer.
You can usually return home the same day after the sedation wears off. You may notice some discomfort in your throat during the next couple of days.
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