Screening for Barrett Esophagus and Esophageal Adenocarcinoma: Approaches and Outcomes.

The incidenceof EAC has risen significantly over the past 4 decades in the United States and other Western countries, and the prognosis of EAC remains poor, with over half of individuals diagnosed at a late stage.

在过去40年中，美国和其他西方国家的食管腺癌（EAC）发病率显著上升，EAC的预后仍然较差，超过一半的患者在晚期被诊断出来。

Despite this, fewer than 1 in 5 eligible individuals undergo endoscopic screening for BE.

尽管如此，符合资格的个体中不到五分之一的人接受食管内镜筛查以检测 Barrett 食管。

Current screening practices rely on upper endoscopy, limiting widespread adoption and missing a significant portion of at-risk individuals.

目前的筛查实践依赖于上消化道内镜检查，这限制了其广泛采用，并且错过了相当一部分高风险个体。

Recent technological advancements in minimally invasive screening modalities have the potential to expand screening efforts, improve detection rates, and reduce healthcare resource utilization.

最近微创筛查方法的技术进步有可能扩大筛查工作，提高检测率，并减少医疗资源的使用。

This review discusses the conceptual underpinnings and hurdles to successful screening for EAC and BE, evaluates newer technologies for screening, including nonendoscopic cell collection devices, blood-based biomarkers, transnasal endoscopy, and exhaled volatile organic compounds, and examines emerging methods for enhancing detection of dysplasia and intestinal metaplasia, including artificial intelligence and wide area transepithelial sampling.

本文讨论了成功筛查食管腺癌(EAC)和 Barrett 食管(BE)的概念基础和障碍，评估了包括非内窥镜细胞采集设备、基于血液的生物标志物、经鼻内窥镜和呼出的挥发性有机化合物在内的新型筛查技术，并检查了增强检测不典型增生和肠上皮化生的新方法，包括人工智能和大面积上皮采样。

The value of screening in light of a recent randomized trial of surveillance from the United Kingdom, as well as a landmark study on nonendoscopic risk stratification for dysplasia in BE, are considered.

在英国最近进行的一项监测随机试验的背景下，以及关于非内镜下食管肠化生（BE）不典型增生风险分层的里程碑式研究中，筛查的价值正在被重新评估。

While direct evidence linking screening to reduced EAC mortality is lacking, trials highlight promising outcomes in early detection of precancerous and cancerous lesions.

尽管缺乏直接证据将筛查与降低食管腺癌（EAC）死亡率直接联系起来，但试验强调了在早期检测癌前病变和癌症病变方面有希望的结果。

Future directions, challenges, and recommendations for optimizing BE screening are discussed.

讨论了优化BE筛查的未来方向、挑战和建议。