Table 2.

Original studies reporting professionals’ views on BE/EAC screening.

Reference	Country	Study design	Test	Professional types and sample size	Key findings relevant to this review
Boolchand et al., 2006	US	Cross-sectional survey	EGD	PCPs (n = 271) Internists (n = 215)Other (n = 56)	•Internists were more likely than family practitioners to refer patients with GERD for endoscopic evaluation (26% vs. 16%, p = 0.005) •Reasons for EGD referral: risk factors, duration/refractoriness/frequency of GERD symptoms, alarm symptoms, diagnostic uncertainty •Reasons for EGD non-referral: cost, poor patient acceptance, insufficient evidence for BE screening, risk of complications •Interest to perform unsedated esophagoscopy in office: 52% of PCPs
Chey et al., 2005	US	Cross-sectional survey	EGD	PCPs (n = 1046)	•87% agreed that patients with GERD (>5 y) should be screened for BE
Kolb et al., 2022	US	Cross-sectional survey	EGD	GIs (n = 120) PCPs (n = 195)	•BE screening is effective for early esophageal cancer detection: 72% of GIs, 71% of PCPs agreed •BE screening reduces all-cause mortality: 23% of GIs, 22% of PCPs agreed •BE screening is cost-effective for at-risk individuals: 56% of GIs, 38% of PCPs agreed •Not performing BE screening poses malpractice liability: 41% of GIs, 26% of PCPs agreed •PCPs should not order BE screening based on lack of recommendation from the USPSTF: 17% of GIs, 29% of PCPs agreed •Better data on the benefits of BE screening are needed: 75% of GIs, 66% of PCPs agreed •Better data on the harms of BE screening are needed: 67% of GIs, 59% of PCPs agreed •A randomized trial on BE screening would impact my decision to refer patients: 90% of GIs, 80% of PCPs agreed •BE screening has equally strong supporting data as CRC screening: 6% of GIs, 5% of PCPs agreed •Provider barriers: difficulty identifying at-risk patients, lack of knowledge of guidelines, ineffective treatment, not my responsibility, competing concerns, insufficient clinic time, unsure about insurance coverage, patient disinterest, patients don’t understand, patient non-adherence
Lin et al., 2002	US	Cross-sectional survey	EGD	GIs (n = 162)	•87% screened patients with GERD (>1 y) •72% believed this is efficacious •48% believed this is cost-effective •Reasons for screening despite disbelieve in effectiveness: patient request, procedure reimbursement, medicolegal
Rubenstein et al., 2008	US	Cross-sectional survey	EGD	GIs (n = 224)	•Clinical practice: 98% would screen males (55 y) with GERD (20 y); 42% would screen females (55 y) with GERD (2 y) •Median perceived preventable deaths following screening and surveillance for EAC: 30% (IQR, 20–50%) •Median perceived preventable deaths following screening for CRC: 75% (IQR, 50–80%) •85% believed EAC screening is less efficacious than CRC screening •Prior malpractice suit was associated with more aggressive screening and surveillance (OR; 3.6, 95% CI; 1.1–12)

Conventional upper endoscopy, EGD; PCP, primary care provider; GI, gastroenterologist; GERD, gastro-esophageal reflux; BE, Barrett’s esophagus; EAC, esophageal adenocarcinoma; IQR, interquartile range; CRC, colorectal cancer; OR, odds ratio.