Benefits

Based on fair evidence, screening would result in no (or minimal) decrease in mortality from esophageal cancer in the U.S. population.

Description of the Evidence

Study Design: Evidence from cohort or case-control studies.

Internal Validity: Fair.

Consistency: Multiple studies.

Magnitude of Effects on Health Outcomes: Small positive.

External Validity: Poor.

Harms

Based on solid evidence, screening would result in uncommon but serious side effects associated with endoscopy which may include perforation, cardiopulmonary events and aspiration, and bleeding requiring hospitalization. Potential psychological harms may occur in those identified as having Barrett esophagus who may consider themselves to be ill even though their risk of developing cancer is low.

Description of the Evidence

Study Design: Evidence obtained from cohort or case-control studies.

Internal Validity: Fair.

Consistency: Multiple studies, large number of participants.

Magnitude of Effects on Health Outcomes: Fair evidence for no reduction in mortality; good evidence for uncommon but serious harms.

External Validity: Poor.

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