Table 5:

Pros and Cons of Non-endoscopic Screening Methods

	Pros	Cons
Esophageal mucosal sampling devices (brushes, balloons, sponges)	• Minimally invasive direct tissue sampling •Can be combined with any molecular test • Low operating cost • High specificity	• Cytology-only yields low sensitivity • Devices are hard to swallow and may lead to poor compliance
Auto-antibodies (blood)	• Non-invasive (serum) • Stable assay	• Low sensitivity
Circulating tumor cells (blood)	• Non-invasive • High specificity • Prognostic value	• Low sensitivity • Not found in early disease
Circulating miRNA (blood	• Non-invasive (detected from plasma or serum) • Stable and consistently expressed • High sensitivity and specificity	•Limited number of studies
Methylated DNA (cell sample or blood)	• Can be non-invasively detected in plasma • Stable and consistently expressed	• Limited number of studies
Volatile Organic Compounds (breath)	• Non-invasive	• Limited number of studies