How to improve dysplasia detection rate and quality in Barrett’s esophagus endoscopic surveillance?

Esophageal cancer is the eighth most common cancer in the world. It has a poor prognosis with a five-year survival of less than 15%-25% and is the sixth most common cause of cancer-related death. The two main histological types of esophageal cancer are esophageal adenocarcinoma (EAC) and squamous cell carcinoma (SCC). In parallel to a decline in SCC, there has been a major increase in the incidence of EAC and associated death in most Western countries over the past thirty years . The incidence of EAC is expected to increase by 140 % over the next ten years. Barrett's Esophagus is a precursor condition for EAC. Risk of progression from BE to EAC is 30–125-fold greater than in the general population. The risk increases progressively with increasing levels of dysplasia. Progression is thought to occur in a stepwise fashion from normal intestinal metaplasia without dysplasia to low-grade to high-grade dysplasia and finally to adenocarcinoma. The poor survival associated with a rising incidence of EAC supports screening and surveillance strategies. The cancer preventive strategy relies on endoscopic surveillance to detect dysplasia and treat early before EAC onset. During my PhD, i will focus on studying key performance measures aiming to improve the quality in BE management.