Barrett's esophagus and adenocarcinoma. The need for a consensus conference.

The fear of cancer has evoked calls for intensive surveillance programs in Barrett's esophagus. Two evolving issues are fueling this fire: (a) the rising risk of adenocarcinoma of the esophagus over the past 20 years and (b) the coincidental increase in the recognized prevalence of Barrett's esophagus in the general population. However, these sobering statistics must be carefully weighed against the lack of adverse effects on survival and the cost of an extensive surveillance program for adenocarcinoma in Barrett's esophagus, the latter estimated at between $(300) and $(1,500) million per year. Barrett's esophagus and its associated cancer risk represent a crisis in gastroenterology. A consensus conference of leading basic and clinical scientists is needed in this area.