Barrett’s Esophagus- High-Grade Dysplasia Overdiagnosis?

Share Button

Is “high-grade dysplasia” in Barrett’s Esophagus Diagnosed too often? Why does it matter?

High-Grade Dysplasia in Barrett’s Esophagus (pre-esophageal cancer), DCIS (pre-breast cancer), and cervical dysplasia (pre-cervical cancer) , etc. have two important things in common. First, all are NOT cancer. Two, all three of these diagnoses can increase your risk of getting cancer. According to the article linked and excerpted below, high-grade dysplasia in Barrett’s Esophagus is WAY over-diagnsosed.

figure cp35337.f10

Make no mistake- any cancer is difficult to assess under a microscope. But the one immutable truth I have learned as a cancer survivor of an incurable cancer, your diagnosis is used to design your treatment plan.

Therefore an accurate diagnosis of your “pre-cancer” is important to you.


Please consider the following-

  1. Get a second opinion
  2. Lower your risk of Barret’s Esophagus  (high or low dysplasia) from becoming Esophageal Cancer through evidence-based nutrition, supplementation and anti-oxidants.

Have you been diagnosed with Barrett’s Esophagus? Do you have heartburn or G.E.R.D? High or low dysplasia? Any symtpoms? Scroll down the page, post a question or a comment and I will reply to you ASAP.


David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Overdiagnosis of High-grade Dysplasia in Barrett’s Esophagus: A Multicenter, International Study

“Numerous histological mimics of high-grade dysplasia in Barrett’s esophagus predispose to overdiagnosis and potential serious mismanagement, including unnecessary esophagectomy…

Observer variability by the study pathologists was assessed through two blinded diagnostic rounds on 437 biopsies from 26 random study endoscopies. Study diagnostic reassessments revealed significantly lower rates of high-grade dysplasia. Only 248 patients (51%) were confirmed to have high-grade dysplasia…

A total of 194 patients (40%) were overdiagnosed with Barrett’s high-grade dysplasia, as affirmed by the extensive screening process and high-level study pathologist agreement. The multiple diagnostic pitfalls uncovered should help raise pathologists’ awareness of this problem and improve diagnostic accuracy.”

figure cp35337.f9

Diagnosis and grading of dysplasia in Barrett’s oesophagus

“Careful attention to the cytological and architectural features of dysplasia, as outlined earlier, and recognition of the extreme degrees of regeneration that may occur in this condition, can help minimise observer error…”

Leave a Comment: