Table 1. Factors leading to the increased detection of esophageal adenocarcinoma at an early stage.

• The liberal use of flexible upper endoscopy to investigate foregut symptoms

• The recognition of the potential for gastroesophageal reflux disease to cause BE, a malignant precursor, and esophageal adenocarcinoma

• Structured screening and surveillance programs for BE to detect early neoplasia prior to the onset of sentinel signs or symptoms

• The establishment of formal biopsy protocols for the assessment of dysplasia or occult invasive cancer in the setting of known BE

• Advancements in endoscopic imaging technologies (e.g., narrow-band imaging, confocal laser endomicroscopy) and vital staining dyes that have facilitated the detection of subtle esophageal mucosal abnormalities harboring early neoplasia

BE, Barrett’s esophagus.