PT - JOURNAL ARTICLE AU - T A Wright AU - M R Gray AU - A I Morris AU - I T Gilmore AU - A Ellis AU - H L Smart AU - M Myskow AU - J Nash AU - R J Donnelly AU - A N Kingsnorth TI - Cost effectiveness of detecting Barrett's cancer. AID - 10.1136/gut.39.4.574 DP - 1996 Oct 01 TA - Gut PG - 574--579 VI - 39 IP - 4 4099 - http://gut.bmj.com/content/39/4/574.short 4100 - http://gut.bmj.com/content/39/4/574.full SO - Gut1996 Oct 01; 39 AB - BACKGROUND: Screening Barrett's oesophagus is controversial owing to a large variation in the reported incidence of neoplastic change and lack of evidence that screening improves tumour prognosis. AIMS: To determine the incidence of Barrett's cancer, its cost of detection, and stage of disease at time of diagnosis. PATIENTS AND METHODS: Data from our surveillance programme have been reviewed to assess the incidence of malignant change, tumour stage at diagnosis, and the cost per cancer detected. RESULTS: 166 patients had annual endoscopic surveillance. Six patients (five men) developed cancer-an incidence of one cancer per 59 male and 167 female patient-years of follow up. The screened group had a significantly earlier stage than a control group of unscreened cancers (p < 0.05). The cost of detecting one cancer was Pounds 14 868 for men and Pounds 42 084 for women. CONCLUSIONS: The cost of screening for Barrett's cancer is high but may be justified on the basis of the high incidence of detecting early stage disease.