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Frequency of Surveillance for Barrett Esophagus—Reply
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In Reply: Dr Sack correctly notes that our patient preferred yearly endoscopy as surveillance for her gastroesophageal reflux disease and Barrett esophagus, and that her physician complied with her request. This is contrary to the recommendation of Dr Spechler in his original Clinical Crossroads publication.1 He felt her risk of developing esophageal cancer was small, no more than 0.5% per year, and that endoscopic surveillance at 3-year intervals should suffice. As Dr Sack notes, Dr Spechler's recommendation remains consistent with current specialty society guidelines.2
In JAMA, Clinical Crossroads chronicles care that was chosen by an actual patient and his or her physician. Many physicians and patients do not follow standard practice guidelines. For example, a recent survey of gastroenterologists found that 50% reported routinely recommending colonoscopy at intervals more frequent than those suggested by published guidelines.3 Above and beyond the particular patient's preference, we do not know if there . . . [Full Text of this Article]
Risa B. Burns, MD;
Tom Delbanco, MD
tdelbanc@bidmc.harvard.edu
Beth Israel Deaconess Medical Center
Boston, Mass
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Frequency of Surveillance for Barrett Esophagus
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