Barrett's esophagus monitoring

If you’ve been diagnosed with Barrett’s esophagus, regular monitoring of the condition helps detect any cellular changes as early as possible. Your team at City of Hope will develop a personalized testing and monitoring plan with a schedule based on your needs, risk factors and diagnosis.

We will use state-of-the-art techniques to sample esophageal tissue at regular intervals. Ongoing testing will help us identify changes in esophageal tissue when they happen and adjust the plan if needed.

Our evidence-based methods are designed to detect cancer as early as possible. Only a small percentage of people with Barrett’s esophagus develop esophageal cancer. But if the condition becomes malignant (cancerous), catching it early may make the disease easier to treat and improve your results.

Your City of Hope gastroenterologist will recommend a surveillance schedule based on the stage of Barrett’s esophagus. In general, our monitoring recommendations may include:

No dysplasia (healthy, unchanged cells)
  —Perform endoscopy every one to three years, depending on the length of the Barrett’s segment

Low-grade dysplasia (abnormal cell changes)
  —Confirm diagnosis and repeat endoscopy in six months

Intermediate dysplasia
  —Perform an endoscopic eradication procedure (endoscopic mucosal resection, radiofrequency ablation or cryotherapy), followed by repeat endoscopy in six months

High-grade dysplasia
  —Perform endoscopic eradication, followed by a repeat procedure in three months and possibly surgery if the condition is persistent

A traditional biopsy technique, taking samples every couple of centimeters, may miss areas with abnormal cells in between. City of Hope now uses a state-of-the-art system to sample a wider area of the esophagus. It’s called WATS^3D (wide-area transepithelial sampling in three dimensions).

This evidence-based technique uses artificial intelligence to detect cells suggestive of precancerous cells that could be missed with the traditional method. It may also detect abnormal cells missed by the biopsy.

While conducting your upper endoscopy, the City of Hope team will use the WATS^3D system’s technique, following this procedure:

1. Inserting a special small brush into the esophagus through the endoscope
2. Rubbing it against abnormal Barrett’s esophagus, capturing cells over a wider area, up to 5 cm/2 inches
3. Using additional brushes for additional areas
4. Sending the brushes to a special laboratory, which analyzes the cells

The WATS^3D lab will then compare your cells to a national database of esophageal cancer cells. This artificial intelligence technique helps the team assess whether cells are abnormal.

Biopsy and WATS^3D results are usually available in a few days. If Barrett’s esophagus is worsening or progressing to precancerous cells (dysplasia), we’ll offer treatment options based on your individual needs.