Response to Drs. Romero and Riddell

therapy was not instituted. Much of the rationale of this report is therefore based on this one individual, in whom a cause of death has not been reported (presumably the patient was still alive at publication). One can question whether this patient should have been in an intervention study or surveillance program at all, given his comorbid state. As much as we would like to think that we are benefiting our patients, we do not as yet have evidence that endoscopic surveillance of classic, long segment Barrett’s esophagus (intestinal metaplasia.3 cm in length) has a significant impact on the prolongation of life. Recommending surveillance endoscopy for a large percentage of the population without a clear idea of the expected outcome seems premature on the data provided. Prospective placebo-controlled studies in larger groups of patients with differing backgrounds need to be done.