Barrett’s esophagus: What you need to know about preventable cancer risk
7/13/2026 by Vijayvardhan Kamalumpundi, M.D., and Cadman Leggett, M.D.
What is Barrett’s esophagus?
Barrett's esophagus is a condition in which the normal lining of the lower esophagus, the tube that carries food from the mouth to the stomach, is replaced by a different type of lining. This most often occurs after years of acid reflux, which is when stomach acid flows back into the esophagus. While Barrett's esophagus is not cancer, it is the only known precursor for esophageal adenocarcinoma, a type of esophageal cancer.
According to a 2022 U.S. study review, about 5% of U.S. adults have Barrett's esophagus. The good news is that most people with Barrett’s esophagus never develop cancer. With appropriate monitoring and treatment, the risk of progression can be significantly reduced.
Symptoms and diagnosis
Barrett's esophagus often causes no symptoms itself. Most people experience symptoms related to acid reflux, such as frequent heartburn, regurgitation of stomach acid (coming back up) or chest discomfort.
Diagnosis requires an upper endoscopy, which is when a flexible camera is used to examine the esophagus. During the procedure, a biopsy of tissue samples is taken to confirm the diagnosis and identify any precancerous changes called dysplasia.
Who is at risk, and who should be screened?
Barrett's esophagus screening is not recommended for everyone. However, many eligible individuals are never screened, leading to missed opportunities for early detection. A 2025 study in The American Journal of Gastroenterology suggested that only 20% of people who meet criteria for Barrett's esophagus undergo screening.
Current clinical practice advice from the American Gastroenterological Association recommends that medical professionals screen patients with at least three of these risk factors:
- Male sex.
- Age over 50.
- White race.
- Obesity or body mass index over 30.
- Any history of smoking
- A family history of Barrett's esophagus or esophageal adenocarcinoma in a first-degree relative, such as a parent, sibling or child.
Obstructive sleep apnea — when you stop breathing while you sleep — is now also a recognized risk factor for Barrett’s esophagus. Although chronic heartburn, also called GERD, is an important risk factor, some people develop Barrett’s esophagus with few or no acid reflux symptoms. For this reason, screening decisions should be based on an individual's overall risk profile rather than symptoms alone.
Treatment and prevention
Treatment is focused on controlling acid reflux, monitoring for precancerous changes and reducing the risk of progression to cancer. Lifestyle changes that can help manage symptoms and medications to reduce the production of stomach acid — particularly proton pump inhibitors — are commonly used.
Patients with Barrett's esophagus typically undergo periodic endoscopies to watch for precancerous changes. If identified, minimally invasive endoscopic therapies can remove or destroy the abnormal tissue and significantly reduce the risk of cancer.
While Barrett's esophagus cannot always be prevented, you may lower your risk by:
- Maintaining a healthy weight.
- Avoiding tobacco.
- Limiting alcohol.
- Seeking early medical evaluation for persistent acid reflux symptoms.
Early detection and appropriate follow up allow most people with Barrett’s esophagus protect their long-term esophageal health.
Vijayvardhan Kamalumpundi, M.D., is an Internal Medicine resident at Mayo Clinic and primary care physician in the Baldwin Building in Rochester, Minnesota. His clinical interests include gastrointestinal endoscopy and diagnosis of esophageal diseases.
Cadman Leggett, M.D., is an Assistant Professor of Medicine in the Division of Gastroenterology and Hepatology at Mayo Clinic and serves as director of the Barrett’s Esophagus Unit in Rochester, Minnesota. His clinical practice focuses on the diagnosis and management of benign and malignant esophageal disorders, with expertise in Barrett’s esophagus.