Cost effectiveness analysis of Barrett's esophagus screening: A systematic review

Abstract

Barrett's esophagus screening is critical for early detection of esophageal adenocarcinoma, but optimal strategies remain debated. This systematic review analyzed thirteen studies evaluating screening cost-effectiveness through September 2024. Both traditional endoscopic and emerging non-endoscopic methods were cost-effective compared to no screening, with incremental cost-effectiveness ratios below standard willingness-to-pay thresholds. Non-endoscopic approaches, particularly swallowed cell collection devices with biomarkers, demonstrated superior cost-effectiveness versus standard endoscopy. Cost-effectiveness improved in populations with higher disease prevalence. Current evidence supports implementing screening programs, especially using non-endoscopic methods in high-risk populations. Future research should focus on validating risk stratification tools to further optimize screening approaches.