Barrett’s oesophagus is the only known precursor to oesophageal adenocarcinoma, a cancer with very poor prognosis. The main risk factors for Barrett’s oesophagus are a history of gastro-oesophageal acid reflux symptoms and obesity. Men, smokers and those with a family history are also at increased risk. Progression from Barrett’s oesophagus to cancer occurs via an intermediate stage, known as dysplasia. However, dysplasia and early cancer usually develop without any clinical signs, often in individuals whose symptoms are well controlled by acid suppressant medications; therefore, endoscopic surveillance is recommended to allow for early diagnosis and timely clinical intervention. Individuals with Barrett’s oesophagus need to be fully informed about the implications of this diagnosis and the benefits and risks of monitoring strategies. Pharmacological treatments are recommended for control of symptoms, but not for chemoprevention. Dysplasia and stage 1 oesophageal adenocarcinoma have excellent prognoses, since they can be cured with endoscopic or surgical therapies. Endoscopic resection is the most accurate staging technique for early Barrett’s-related oesophageal adenocarcinoma. Endoscopic ablation is effective and indicated to eradicate Barrett’s oesophagus in patients with dysplasia. Future research should focus on improved accuracy for dysplasia detection via new technologies and providing more robust evidence to support pathways for follow-up and treatment.

中文翻译：

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美国国家健康与护理卓越研究所 (NICE) 关于巴雷特食管和 I 期食管腺癌监测和管理的指南

巴雷特食管是食管腺癌唯一已知的前兆，食管腺癌是一种预后极差的癌症。巴雷特食管的主要危险因素是胃食管反流症状和肥胖病史。男性、吸烟者和有家族史的人也面临更高的风险。从巴雷特食管进展到癌症需要经历一个中间阶段，称为发育不良。然而，发育异常和早期癌症通常在没有任何临床症状的情况下发生，通常发生在通过抑酸药物可以很好地控制症状的个体中；因此，建议进行内镜监测，以便早期诊断和及时的临床干预。巴雷特食管患者需要充分了解该诊断的影响以及监测策略的益处和风险。建议使用药物治疗来控制症状，但不建议进行化学预防。不典型增生和一期食管腺癌具有良好的预后，因为它们可以通过内窥镜或手术治疗治愈。内镜切除术是早期巴雷特相关食管腺癌最准确的分期技术。内镜消融术是有效的，可以根除发育不良患者的巴雷特食管。未来的研究应侧重于通过新技术提高异型增生检测的准确性，并提供更强有力的证据来支持随访和治疗途径。