Barrett’s oesophagus is common and there is evidence that it is becoming more common. This is significant because of the malignant potential of the condition. The professional gastroenterology societies of the UK and USA now recommend 2–3 yearly endoscopic surveillance with systematic biopsies for those diagnosed with Barrett’s oesophagus. However, surveillance is controversial because the number of patients identified with early cancer is relatively small for the large amount of work that is required. In the future it is hoped that new imaging techniques should help target biopsies more effectively and new therapeutic endoscopic techniques should enable some patients to avoid mutilating surgery and offer therapy to patients who had previously been considered unfit for surgery. At present, chemoprevention and population screening for Barrett’s oesophagus offer the best chance of reducing the current considerable national mortality from oesophageal cancer.
