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DOI: 10.1055/a-2662-7978
Curriculum for optical diagnosis of esophageal neoplasia and precursor lesions: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Main statements
Pre-adoption
Endoscopists performing upper gastrointestinal (UGI) endoscopy should train to recognize the appearance of early esophageal cancer and its precursor lesions, for Barrett neoplasia and for squamous neoplasia, to improve detection rates.
Every endoscopist should have achieved competency in UGI endoscopy before commencing training in optical diagnosis in the UGI tract, and this requires personal experience of 300 UGI endoscopies and meeting the ESGE quality measures for UGI endoscopy.
Training
Endoscopists should undertake interactive training courses to improve diagnostic accuracy for esophageal preneoplastic and neoplastic lesions.
Endoscopists should train with the Barrett’s Oesophagus-Related Neoplasia (BORN) module to improve detection and delineation for early Barrett’s esophagus-related neoplasia.
Endoscopists should train in using the Prague classification to describe the circumferential and maximal extent of Barrett epithelium above the gastroesophageal junction.
Endoscopists should train in using the Paris classification to describe suspected neoplastic lesions within both Barrett and squamous epithelium.
Endoscopists should train in using virtual chromoendoscopy to assess both mucosal and vascular patterns in potentially neoplastic lesions in Barrett epithelium as being regular or irregular.
When using acetic acid chromoendoscopy for Barrett’s esophagus inspection, endoscopists should be familiar with the appearance of neoplastic lesions by assessing loss of aceto-whitening and mucosal surface patterns.
Endoscopists should train in using the Japanese Esophageal Society (JES) classification to describe esophageal squamous cell lesions, to estimate the likelihood of and degree of dysplasia, and in the case of squamous cell cancer, the invasion depth.
Publikationsverlauf
Artikel online veröffentlicht:
26. August 2025
© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved..
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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References
- 1 Dekker E, Houwen BBSL, Puig I. et al. Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2020; 52: 899-923
- 2 Rice TW, Patil DP, Blackstone EH. 8th edition AJCC/UICC staging of cancers of the esophagus and esophagogastric junction: application to clinical practice. Ann Cardiothorac Surg 2017; 6: 119-130
- 3 Pech O, Behrens A, May A. et al. Long-term results and risks factor analysis for recurrence after curative endoscopic therapy in 349 patients with high grade intraepithelial neoplasia and mucosal adenocarcinoma in Barrett’s oesophagus. Gut 2008; 57: 1200-1206
- 4 Van Munster SN, Nieuwenhuis E, Weusten BLAM. et al. Long-term outcomes after endoscopic treatment for Barrett's neoplasia with radiofrequency ablation ± endoscopic resection: results from the national Dutch database in a 10-year period. Gut 2022; 71: 265-276
- 5 Weusten BLAM, Bisschops R, Dinis-Ribeiro M. et al. Diagnosis and management of Barrett esophagus: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2023; 55: 1124-1146
- 6 Ryu Ishihara R, Arima M, Iizuka T. et al. Endoscopic submucosal dissection/endoscopic mucosal resection guidelines for esophageal cancer. Dig Endosc 2020; 32: 452-493
- 7 Wani S, Holmberg D, Santoni G. et al. Magnitude and time-trends of post-endoscopy esophageal adenocarcinoma and post-endoscopy esophageal neoplasia in a population-based cohort study: The Nordic Barrett’s Esophagus Study. Gastroenterology 2023; 165: 909-919.e13
- 8 Alexandre L, Tsilegeridis-Legeris T, Lam S. Clinical and endoscopic characteristics associated with post-endoscopy upper gastrointestinal cancers: a systematic review and meta-analysis. Gastroenterology 2022; 162: 1123-1135
- 9 Bisschops R, Areia M, Coron E. et al. Performance measures for upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2016; 48: 843-864
- 10 Ward ST, Hancox A, Mohammed MA. et al. The learning curve to achieve satisfactory completion rates in upper GI endoscopy: an analysis of a national training database. Gut 2017; 66: 1022-1033
- 11 Miller AT, Sedlack RE. ACE Research Group. Competency in esophagogastroduodenoscopy: a validated tool for assessment and generalizable benchmarks for gastroenterology fellows. Gastrointest Endosc 2019; 90: 613-620.e1
- 12 Daly C, Vennalaganti P, Soudagar S. et al. Randomized controlled trial of self-directed versus in-classroom teaching of narrow-band imaging for diagnosis of Barrett’s esophagus-associated neoplasia. Gastrointest Endosc 2016; 83: 101-106
- 13 Xue H, Gong S, Shen Y. et al. The learning effect of a training programme on the diagnosis of oesophageal lesions by narrow band imaging magnification among endoscopists of varying experience. Dig Liver Dis 2014; 46: 609-615
- 14 Bergman JJGHM, De Groof AJ, Pech O. International Working Group for Classification of Oesophagitis. et al. An interactive web-based educational tool improves detection and delineation of Barrett’s esophagus-related neoplasia. Gastroenterology 2019; 156: 1299-1308
- 15 Sharma P, Dent J, Armstrong D. et al. The development and validation of an endoscopic grading system for Barrett’s esophagus: the Prague C & M criteria. Gastroenterology 2006; 131: 1392-1399
- 16 Vahabzadeh B, Seetharam AB, Cook MB. et al. Validation of the Prague C & M criteria for the endoscopic grading of Barrett’s esophagus by gastroenterology trainees: a multicenter study. Gastrointest Endosc 2012; 75: 236-241
- 17 Alvarez Herrero L, Curvers WL, van Vilsteren FG. et al. Validation of the Prague C&M classification of Barrett’s esophagus in clinical practice. Endoscopy 2013; 45: 876-882
- 18 Hamade N, Vennelaganti S, Parasa S. et al. Lower annual rate of progression of short-segment vs long-segment Barrett’s esophagus to esophageal adenocarcinoma. Clin Gastroenterol Hepatol 2019; 17: 864-868
- 19 Chandrasekar VT, Hamade N, Desai M. et al. Significantly lower annual rates of neoplastic progression in short- compared to long-segment non-dysplastic Barrett’s esophagus: a systematic review and meta-analysis. Endoscopy 2019; 51: 665-672
- 20 Pohl H, Pech O, Arash H. et al. Length of Barrett’s oesophagus and cancer risk: implications from a large sample of patients with early oesophageal adenocarcinoma. Gut 2016; 65: 196-201
- 21 The Paris endoscopic classification of superficial neoplastic lesions. esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc 2003; 58 (Suppl. 06) S3-S43
- 22 Pech O, Gossner L, Manner H. et al. Prospective evaluation of the macroscopic types and location of early Barrett’s neoplasia in 380 lesions. Endoscopy 2007; 39: 588-593
- 23 Peters FP, Brakenhoff KP, Curvers WL. et al. Histological evaluation of resection specimens obtained at 293 endoscopic resections in Barrett’s esophagus. Gastrointest Endosc 2008; 67: 604-609
- 24 Pimentel-Nunes P, Libânio D, Bastiaansen BAJ. et al. Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022. Endoscopy 2022; 54: 591-622
- 25 Sharma P, Bergman JJGHM, Goda K. et al. Development and validation of a classification system to identify high-grade dysplasia and esophageal adenocarcinoma in Barrett’s esophagus using narrow-band imaging. Gastroenterology 2016; 150: 591-598
- 26 Subramaniam S, Kandiah K, Schoon E. et al. Development and validation of the international Blue Light Imaging for Barrett’s Neoplasia Classification. Gastrointest Endosc 2020; 91: 310-320
- 27 Lipman G, Bisschops R, Sehgal V. et al. Systematic assessment with I-SCAN magnification endoscopy and acetic acid improves dysplasia detection in patients with Barrett’s esophagus. Endoscopy 2017; 49: 1219-1228
- 28 Kandiah K, Chedgy FJQ, Subramaniam S. et al. International development and validation of a classification system for the identification of Barrett’s neoplasia using acetic acid chromoendoscopy: the Portsmouth acetic acid classification (PREDICT). Gut 2018; 67: 2085-2091
- 29 Chedgy FJQ, Kandiah K, Barr H. et al. Development and validation of a training module on the use of acetic acid for the detection of Barrett’s neoplasia. Endoscopy 2017; 49: 121-129
- 30 Oyama T, Inoue H, Arima M. et al. Prediction of the invasion depth of superficial squamous cell carcinoma based on microvessel morphology: magnifying endoscopic classification of the Japan Esophageal Society. Esophagus 2017; 14: 105-112
- 31 Minami H, Isomoto H, Inoue H. et al. Significance of background coloration in endoscopic detection of early esophageal squamous cell carcinoma. Digestion 2014; 89: 6-11
- 32 Messmann H, Bisschops R, Antonelli G. et al. Expected value of artificial intelligence in gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2022; 54: 1222-1231
- 33 Hassan C, Ponchon T, Bisschops R. et al. European Society of Gastrointestinal Endoscopy (ESGE) publications policy – Update 2020. Endosocpy 2020; 52: 123-126