[Barrett esophagus--an increasing problem].

There has been a considerable increase in the incidence of adenocarsinoma in the proximal stomach (cancer of the cardia) and distal oesophagus (Barrett's cancer) for the past 20 years. There is probably also a parallel increase in the pathogenetically related conditions reflux oesophagitis and Barrett's oesophagus. In patients with classical Barrett's oesophagus, i.e., metaplastic changes in the mucosa more than 3 cm up from the gastro-oesophageal junction, a follow-up programme with endoscopy and adequate biopsies is recommended in cases where a finding of premalignant changes or malignancy will have therapeutic consequences. In "short segment" Barrett's oesophagus it is still not clear how extensive the biopsy and follow-up programme should be. It is also not clear whether other tests should be performed. Screening for malignancy, possibly by means of cancer-markers, and local treatment modalities of (pre-) malignant changes, are interesting possibilities that are being investigated.