Screening for esophageal squamous cell carcinoma: insight from experience with Barrett's esophagus

We read with great interest the article by Codipilly et al,1 which reviewed recent advances in screening for esophageal squamous cell carcinoma (ESCC) and its precursor, including endoscopic and nonendoscopic modalities. Mass endoscopic screening would present a cost-effective challenge and is not tenable in most high-incidence regions except in a few ultra–high-prevalence areas.2,3 Esophageal balloon cytology screening was once widely used in China but is no longer recommended because of its low accuracy in asymptomatic individuals.

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