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Lung Cancer Screening — USMLE Step 2 CK MCQ

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HardRespiratory MedicineLung Cancer ScreeningUSMLE Step 2 CK

A 59-year-old man with chronic reflux has a 2-cm segment of Barrett esophagus. High-quality biopsies show intestinal metaplasia without dysplasia. Symptoms are controlled with a proton-pump inhibitor. Which management is most appropriate?

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Correct answer: C — Surveillance endoscopy in 3-5 years

Nondysplastic Barrett esophagus has a relatively low annual progression risk, so surveillance is generally performed at 3-5-year intervals while reflux is treated. Ablation is reserved for confirmed dysplasia or selected early neoplasia, and esophagectomy is not justified for nondysplastic metaplasia. Six-month endoscopy is excessive, whereas symptom control does not eliminate cancer risk or the need for surveillance.

Reference: American College of Gastroenterology: Barrett's Esophagus. https://gi.org/topics/barretts-esophagus/