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Table 9 Common problems encountered with Barrett's surveillance

From: Barrett's oesophagus and adenocarcinoma

• Dysplastic lesions are often flat and indistinguishable endoscopically
• Variations in diagnostic criteria for Barrett's oesophagus and dysplasia
• Wide variations in local protocols (e.g. how often surveillance should be conducted if at all, the number of biopsies)
• Imaging protocols do not achieve subcellular resolution and biopsies are still required
• Submucosal deep abnormalities may not be detected even when the area is biopsied
• Sampling bias (dysplasia may be focal, patchy or diffuse)
• Surveillance is time consuming and costly