Patient Knowledge, Risk Perception, and Barriers to Barrett's Esophagus Screening : Official journal of the American College of Gastroenterology | ACG

Secondary Logo

Journal Logo


Patient Knowledge, Risk Perception, and Barriers to Barrett's Esophagus Screening

Kolb, Jennifer M. MD, MS1; Chen, Mindy MD2; Tavakkoli, Anna MD, MSc3; Gallegos, Jazmyne BA4; O'Hara, Jack BA4; Tarter, Wyatt MS5; Hochheimer, Camille J. PhD5; Golubski, Bryan MD6; Kopplin, Noa BS3; Hennessey, Lilly BA7; Kalluri, Anita BA7; Devireddy, Shalika4; Scott, Frank I. MD, MSCE4; Falk, Gary W. MD, MS7; Singal, Amit G. MD, MS3; Vajravelu, Ravy K. MD, MSCE8; Wani, Sachin MD4

Author Information
The American Journal of Gastroenterology 118(4):p 615-626, April 2023. | DOI: 10.14309/ajg.0000000000002054



Most patients with esophageal adenocarcinoma (EAC) do not have a previous diagnosis of Barrett's esophagus (BE), demonstrating a failure of current screening practices. An understanding of patient attitudes and barriers is essential to develop and implement interventions to improve BE screening adherence.


We conducted a Web-based survey of patients aged >50 years with chronic gastroesophageal reflux disease at 3 academic medical centers and 1 affiliated safety net health systems. Survey domains included patient characteristics, endoscopy history, familiarity with screening practices, perceived BE/EAC risk, and barriers to screening.


We obtained a response rate of 22.6% (472/2,084) (74% men, mean age 67.9 years). Self-identified race and ethnicity of participants was 66.5% non-Hispanic White, 20.0% non-Hispanic Black, 13.4% other race, and 7.1% Hispanic. Screening for BE was recommended in only 13.2%, and only 5.3% reported previous screening. Respondents had notable gaps in knowledge about screening indications; only two-thirds correctly identified BE risk factors and only 19.5% believed BE screening was needed for gastroesophageal reflux disease. More than 1 in 5 respondents believed they would get BE (31.9%) or EAC (20.2%) but reported barriers to screening. Compared with White respondents, more Black respondents were concerned about getting BE/EAC and interested in screening but report higher barriers to screening.


Patients at risk for BE, particularly racial and ethnic minorities, are worried about developing EAC but rarely undergo screening and have poor understanding of screening recommendations.

© 2022 by The American College of Gastroenterology

Full Text Access for Subscribers:

You can read the full text of this article if you:

Access through Ovid