Diagnosis and treatment of barrett's esophagus in the west

Esophagogastric cancers remain some of the most difficult cancers to treat, accounting for approximately 16% of cancer-related mortality worldwide. The emergence of advanced diagnostic techniques including high resolution high definition white light endoscopy, chromoendoscopy, electronic chromoendoscopy and more recently technological advancement in artificial intelligence have assisted Endoscopists in detecting premalignant and malignant lesions within the esophagus. Traditionally, the gold standard of treatment for esophagogastric cancer has been surgery, even at the earliest stages of malignancy. However, these procedures are associated with increased rates of treatment-related morbidity and mortality. Over the past decade, minimally invasive endoscopic management have become a viable alternative to surgical treatment. Ultimately, the mode of management of these lesions is determined by local factors, including the patient’s age, comorbidities and personal preference, as well as the available expertise. We will discuss the western approach in the diagnosis and management of Barrett’s dysplasia and early esophageal cancer detailing present standards of care, challenges and controversies.