0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

Screening and Barrett's Esophagus

David E. Langdon, MD
Arch Intern Med. 1997;157(10):1139. doi:10.1001/archinte.1997.00440310105011.
Text Size: A A A
Published online

In their excellent review, "Clinical Implications of Barrett's Esophagus,"1 Crooks and Lichtenstein mention the screening frequency in the flow diagram, "biopsy every 1-2 y," and totally ignore the critical concerns of cost. Many gastroenterologists favor yearly screening. National seminar discussants, although data are scant, often lump screening, the more common short-segment variety, with the traditional long-segment Barrett's, thereby greatly increasing the numbers. However, Provenzale et al2 modeled the patient and cost issues. Screening just every 4 years cost $276 000 per additional "quality-of-life year" gained.2 Yearly screening was nearly off the scale! Crooks and Lichtenstein cited the advantages of "mapping" using individual biopsy specimens from defined sites.1 Outside the academic world, processing charges are à la carte per bottle, although professional fees may reach a cap. Individualizing multiple biopsy specimens can add more than $1000. The time, risks, and facility charges of the endoscopy also increase.

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();