Table 1.

Summary of Recommendations and Implementation Considerations

Recommendations	Strength of Recommendation	Certainty of Evidence
In individuals with Barrett’s esophagus with high grade dysplasia, the AGA recommends endoscopic eradication therapy over surveillance.	Strong	Moderate
Implementation Considerations for Recommendation #1: 1a)Following completion of EET, surveillance should be performed at 3, 6, and 12 months, then annually. 1b)Surveillance endoscopies following EET should obtain targeted tissue sampling of visible lesions and random biopsies of the cardia and distal 2cm of the tubular esophagus.
2.In individuals with Barrett’s esophagus with low grade dysplasia, the AGA suggests for endoscopic eradication therapy over surveillance. Patients who place a higher value on the well-defined harms, and lower value on the uncertain benefits regarding reduction of esophageal cancer mortality would reasonably select surveillance endoscopy.	Conditional	Low
Implementation Considerations for Recommendation #2: 2a)Following completion of EET, surveillance should be performed at year 1 and 3 after CEIM, then revert to surveillance intervals used in non-dysplastic BE. 2b)The tissue sampling protocol during surveillance should be performed the same as in surveillance following EET for HGD.
3.In individuals with non-dysplastic Barrett’s esophagus, the AGA suggests against the routine use of endoscopic eradication therapy.	Conditional	Very Low
4.In patients undergoing endoscopic eradication therapy, the AGA suggests resection of visible lesions followed by ablation of the remaining BE segment over resection of the entire BE segment.	Conditional	Very Low
Implementation Considerations for Recommendation #4: 4a)In patients with only a small area of BE beyond the visible lesion, completion endoscopic resection in the same setting is acceptable and may be preferred over repeated procedure to perform ablation. 4b)RFA is the preferred ablative modality.
5.In individuals with BE with visible neoplastic lesions that are undergoing endoscopic resection, the AGA suggests the use of either endoscopic mucosal resection or endoscopic submucosal dissection based on lesion characteristics.	Conditional	Very Low
Implementation Considerations for Recommendation #5: 5a)Patients suspected of having T1 EAC should be referred for consideration of EET. 5b)Endoscopic resection is the test of choice over endoscopic ultrasound for distinguishing EAC from HGD and for staging depth of invasion in early cancer. 5c)The vast majority of neoplastic lesions may be managed with EMR rather than ESD 5d)Patients with large bulky neoplastic lesions or lesions highly suspicious of at least T1b invasion (for instance those with depressed, Paris IIc or IIa+c lesions) and deemed candidates for endoscopic resection might benefit from ESD over EMR. 5e)Patients with previously failed EMR might benefit from ESD.