Who defines Barrett's oesophagus: endoscopist or pathologist?

The diagnosis of Barrett's oesophagus has traditionally relied on the ident ification of a 3-cm segment of endoscopically abnormal epithelium (columnar ) in the distal oesophagus. More recently, the presence of intestinal metap lasia has become essential. The importance of the definition relates to the identification of the risk of cancer development. These factors are discus sed in the context of the rising incidence of adenocarcinoma, and the relat ive contributions of endoscopists and pathologists in determining likely pr ogression are explored. We also discuss the advances in endoscopic technolo gy that may aid the endoscopist in predicting malignant progression. Eur J Gastroenterol Hepatol 13:97-99 (C) 2001 Lippincott Williams & Wilkins.