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Surveillance of #Barretts is part of cancer reduction strategy because of well-defined sequence. #FGDebate

Surveillance has to be done well i.e. good inspection, lots of biopsies, good pathology. Otherwise, it is a waste of time. #FGDebate

Biopsy all visible lesions and use Seattle Protocol (4 biopsies every 2cm). Sampling bias is a real problem. #FGDebate

What do you all think? #FGDebate

Some people ask whether given the low conversion rate we should do surveillance? #FGDebate

Risk varies with length of #Barretts and presence of IM. So should tailor surveillance accordingly #FGDebate

Endoscopic treatment has massive impact since confirmed dysplasia picked up on surveillance is now treated. #FGDebate

Enough data on increased cancer risk in dysplasia for NICE to recommend ablation therapy. #FGDebate

Need better ways to objectively risk-stratify #FGDebate Ian Rowe

Consensus reporting of dysplasia essential to avoid over diagnosis and over treatment. #FGDebate

Talk to your pathologist about p53 as an adjunct to diagnosing dysplasia. It is really useful! #FGDebate

Rebecca Fitzgerald Ian Forgacs Here is the link to the BSG guidelines on this bsg.org.uk/clinical-guide… #FGDebate

Great thing about #Cytosponge is can use it in primary care, little sampling bias and objective biomarker to diagnose #Barretts #FGDebate

Ian Forgacs Is this the case of centralisation the Dutch have advocated? #FGDebate

Advanced imaging needs skilled endoscopists to interpret the images, which can have very subtle changes #FGDebate

#FGDebate x.com/RC_Fitzgerald/…

This is where the #Cytosponge could also be advantageous. Just need to determine biomarkers for surveillance but p53 looks good #FGDebate

Just to emphasize that ablation is for dysplasia and not for everyone. #FGDebate

#FGDebate

Main points: - do surveillance well - get your pathologist to do p53 IHC - Cytopsonge might save on endoscopy. Watch that space! #FGDebate