Who is recommended to be screened for Barrett's esophagus?

Barrett's esophagus is a condition that often arises due to chronic gastroesophageal reflux disease (GERD) and is characterized by changes in the cells of the esophagus that can precede the development of esophageal adenocarcinoma. Screening for Barrett's esophagus is particularly recommended for patients who have had long-standing GERD, especially in those over the age of 50. This age threshold aligns with increased risks associated with age and the likelihood of developing dysplasia or cancer due to prolonged exposure to acid from reflux. Individuals with chronic GERD who also present additional risk factors, such as being over 50, are considered for surveillance endoscopy to monitor for precancerous changes.

Other potential candidates for screening include those who may have a higher risk profile, such as patients with a family history of esophageal cancer, yet this alone is not a standard indication without the presence of GERD symptoms. Younger patients and those without gastrointestinal symptoms generally do not meet the criteria for screening, as their risk of developing Barrett's esophagus and related complications is significantly lower. Therefore, patients with a history of GERD who are over the age of 50 represent the group most closely associated with the need for screening based on current medical guidelines.