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Barrett's Surveillance — RACP Adult Medicine MCQ

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HardGastroenterology & HepatologyBarrett's SurveillanceRACP Adult Medicine

A fit 68-year-old has a 5-cm segment of Barrett oesophagus. Two expert-reviewed endoscopies using an adequate biopsy protocol show no dysplasia. Which surveillance interval is appropriate under the Australian guideline?

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Correct answer: D — Repeat endoscopy about every two to three years while surveillance remains consistent with his health and preferences

The best answer is “Repeat endoscopy about every two to three years while surveillance remains consistent with his health and preferences”. Australian guidance uses a shorter interval for long-segment non-dysplastic Barrett oesophagus than for segments under 3 cm; approximately two to three years is appropriate when the patient remains fit enough to benefit. Three-monthly surveillance and surgery are disproportionate without dysplasia, while ten-year or no follow-up underestimates continuing cancer risk.

Reference: Cancer Council Australia: Barrett oesophagus clinical guidelines: https://www.cancer.org.au/health-professionals/clinical-practice-guidelines/barretts-oesophagus