Innovative Screening Method Aims to Detect Barrett's Esophagus Early

A recent study conducted by researchers at the VA Northeast Ohio Healthcare System and Case Western University has revealed a promising new method for early detection of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC). The study, published on June 9, 2025, in The American Journal of Gastroenterology, highlights the effectiveness of a combined screening method that utilizes EsoCheck (EC) and EsoGuard (EG), which demonstrates superior sensitivity and negative predictive value compared to traditional endoscopy.

Barrett's esophagus, a condition that increases the risk of developing EAC, is notably more prevalent in veterans, presenting a significant public health challenge. According to Dr. Katarina B. Greer, lead researcher and a physician at the VA Northeast Ohio Healthcare System, this method could potentially enhance screening rates and reduce patient anxiety associated with invasive procedures. The study involved 782 eligible veterans, out of which 130 participated, with 124 completing the screening process.

The dual approach combines a nonendoscopic esophageal balloon cell-sampling device with a DNA-based precancer screening assay. Initial findings indicate that the combined EC/EG method achieved a sensitivity of 92.9% and a negative predictive value of 98.6%, suggesting it could serve as a first-line screening tool for a broader patient demographic. The significance of these findings is underscored by the fact that EAC diagnoses in the U.S. have surged more than six-fold over the past four decades, with 21,560 new cases reported in 2023 alone.

The study's authors emphasized the limitations of current screening guidelines, which typically recommend endoscopies for patients with chronic gastroesophageal reflux disease (GERD) and additional risk factors such as obesity, smoking, and family history. Notably, a substantial 40% of EAC patients do not present GERD symptoms and are thus overlooked by existing screening protocols. Dr. Greer and her team advocate for expanded screening efforts, particularly for individuals with a familial history of BE, as such patients exhibit a prevalence rate of 23%.

In addition to improving detection rates, the study's results suggest that the proposed screening method could reduce the burden of screening procedures by over half, significantly alleviating the strain on healthcare resources. The estimated population eligible for screening ranges from 19.7 million to 120.1 million in the U.S. Dr. Joshua Sloan, an esophageal gastroenterologist at the University of Minnesota Medical Center, echoed the potential of this nonendoscopic screening tool, asserting its importance in addressing the rising rates of EAC.

While the study represents a significant advancement in gastrointestinal health, further research is necessary to establish its effectiveness in broader populations beyond veterans. Additionally, a cost-effectiveness analysis is underway to evaluate the financial implications of implementing this screening strategy on a nationwide scale. As the healthcare community looks toward innovative solutions for increasing early detection of BE and EAC, the insights from this study may pave the way for improved patient care and outcomes.