Australian clinical practice guidelines for BE and EAC

David C Whiteman, Mark Appleyard, Farzan F Bahin, Yuri V Bobryshev, Michael J Bourke, Ian Brown, Adrian Chung, Andrew Clouston, Emma Dickins, Jon Emery, Guy D Eslick, Louisa G Gordon, Florian Grimpen, Geoff Hebbard, Laura Holliday, Luke F Hourigan, Bradley J Kendall, Eric YT Lee, Angelique Levert‐Mignon, Reginald V Lord, Sarah J Lord, Derek Maule, Alan Moss, Ian Norton, Ian Olver, Darren Pavey, Spiro Raftopoulos, Shan Rajendra, Mark Schoeman, Rajvinder Singh, Freddy Sitas, B Mark Smithers, Andrew C Taylor, Melissa L Thomas, Iain Thomson, Henry To, Jutta von Dincklage, Christine Vuletich, David I Watson, Ian F Yusoff

Barrett's esophagus (BE), a common condition, is the only known precursor to esophageal adenocarcinoma (EAC). There is uncertainty about the best way to manage BE, since most people with BE never develop EAC and most patients diagnosed with EAC have no preceding diagnosis of BE. Moreover, there have been recent advances in knowledge and practice about the management of BE and early EAC. To aid clinical decision-making in this rapidly moving field, Cancer Council Australia convened an expert working party to identify pertinent clinical questions. The questions covered a wide range of topics including endoscopic and histologic definitions of BE and early EAC; prevalence, incidence, natural history and risk factors for BE; and methods for managing BE and early EAC. The latter considered modification of lifestyle factors; screening and surveillance strategies; and medical, endoscopic and surgical interventions. To answer each question, the working party systematically reviewed the literature and developed a set of recommendations through consensus. Evidence underpinning each recommendation was rated according to quality and applicability.