The incidence of esophageal adenocarcinoma (EAC) has continued to increase, with a poor 5-year survival rate of ~20%. Barrett's esophagus is the only recognized precursor to EAC, so public health strategies focus on identifying and screening high-risk populations. Currently, the standard screening method is sedated esophagogastroduodenoscopy. However, this approach has challenges, including its invasive nature, need for sedation, higher cost, procedure-related risks, sampling error, and poor suitability for population-wide screening. As a result, alternative screening techniques such as transnasal endoscopy and less invasive options including non-endoscopic cell collection devices with biomarker assays have been explored. In this review, we summarize current approaches for identifying at-risk populations and screening methods and provide insights into technologies that could complement screening strategies in the future.

Eosinophilic Esophagitis (EoE) is a chronic inflammatory esophageal disorder, often complicated by strictures requiring dilation. There is limited information on the target esophageal luminal diameter (ELD) post-treatment to relieve symptoms. The aim of this study was to determine the ELD threshold associated with dysphagia resolution in EoE patients in histologic remission. We performed a retrospective cohort study of adult EoE patients with a stricture in histologic remission. Patients were excluded if symptoms, EoE endoscopic reference score (EREFS), and ELD were missing. ELD was estimated by dilator diameter, endoscope passage, or functional lumen imaging probe. Symptoms, demographics, EREFS, and histology were recorded. Univariate and multivariable logistic regression analyses were performed. The ELD threshold for dysphagia was determined using receiver operating characteristics analyses. Of the 76 patients who met criteria, 63 (82.9

Background Achalasia is a rare progressive disease for which longitudinal outcomes and optimal follow-up remain poorly defined. We assessed longitudinal reintervention, symptom palliation, and esophageal emptying after Heller myotomy performed in more than 1000 patients over a 25-year period. Methods Between January 1, 1995, and January 1, 2020, a total of 1010 adults underwent Heller myotomy at Cleveland Clinic. The operation was minimally invasive in 937 (93%) patients, with Dor fundoplication in 838 (92%). Esophageal emptying was assessed by timed barium esophagram (TBE), and symptoms were quantified by Eckardt score. Multiphase mixed-effects models and Kaplan-Meier analysis were used to estimate longitudinal symptom palliation, esophageal emptying, and reintervention (pneumatic dilation ≥30 mm, per-oral endoscopic myotomy, repeat Heller myotomy, or esophagectomy). Results Freedom from any reintervention was 75% and freedom from esophagectomy was 96.8% at 10 years postmyotomy. The risk of reintervention was greatest during the first year, with 1 reintervention portending additional reintervention(s). Severe recurrent symptoms were rare, with a probability of freedom from severe dysphagia (daily or every meal) of 74% and probability of an Eckardt score ≤3 of 68% at 10 years. The probability of complete TBE emptying was 55% immediately postmyotomy and decreased to 24% by 10 years. Conclusions Heller myotomy provides long-term symptom palliation and esophageal emptying for patients with achalasia, with a gradually increasing risk of reinterventions over time, highlighting the importance of initial annual follow-up. After 3 years, the follow-up interval may be increased to every 3 years when symptom relief and esophageal emptying remain stable. These findings provide a long-term benchmark for future therapies.