Comparative Cost Effectiveness of Reflux-Based and Reflux-Independent Strategies for Barrett's Esophagus Screening.

"CONFLICTS OF INTEREST Guarantor of the article: Prasad G. Iyer, MD, MSc. Specific author contributions: S.S.S. contributed to the study concept and design, acquisition of data, analysis, interpretation of data, and drafted the manuscript. J.P.M. contributed to the acquisition of data, statistical analysis, drafting of the manuscript, and critical revision of the manuscript for important intellectual content. J.K.R. contributed to the acquisition of data, statistical analysis, and critical revision of the manuscript for important intellectual content. B.J.B. contributed to the acquisition of data, statistical analysis, and critical revision of the manuscript for important intellectual content. J.B.K. contributed to the study concept and critical revision of the manuscript for important intellectual content. D.A.K. contributed to the study concept and critical revision of the manuscript for important intellectual content. K.K.W. contributed to the study concept and critical revision of the manuscript for important intellectual content. K.R. contributed to the study concept and design and critical revision of the manuscript for important intellectual content. J.H.R. contributed to the study concept and design and critical revision of the manuscript for important intellectual content. P.G.I. contributed to study concept and design, acquisition of data, analysis and interpretation of data, critical revision of the manuscript for important intellectual content, obtained funding, and study supervision. Financial support: This work was partially supported by grants from the National Cancer Institute (CA241164 to PGI and JBK, U01CA199336 to JHR), the Department of Veterans Affairs (I01-CX000899 to JHR), and the Freeman Foundation. Potential competing interests: S.S.S.: No relevant disclosures. J.P.M.: No relevant disclosures. J.K.R.: No relevant disclosures. B.J.B.: No relevant disclosures. D.A.K.: Consultant Shire. K.K.W.: Research funding from Nine Point Medical, C2 therapeutics, Olympus, Medtronic, and Boston Scientific. J.B.K.: Research funding from Exact Sciences. P.G.I.: Research funding from Exact Sciences and C2 Therapeutics Consultant: Medtronic and Symple Surgical. J.H.R.: No relevant disclosures. K.R.: No relevant disclosures. Mayo Clinic is a minor equity investor in Exact Sciences. J.B.K. is a coinventor on technology licensed to Exact Sciences.Study HighlightsWHAT IS KNOWN✓ Minimally invasive nonendoscopic methods for Barrett’s esophagus (BE) screening have promising performance characteristics compared with sedated endoscopy.✓ BE screening is cost effective in white 50-year-old men with chronic gastroesophageal reflux disease (GERD).WHAT IS NEW HERE✓ Multiple endoscopic and nonendoscopic minimally invasive BE screening strategies were compared in 1 model with no screening and with each other, in both GERD-based and GERD-independent population scenarios.✓ Screening individuals aged 50 years old in a GERD-independent manner with minimally invasive nonendoscopic tests is cost effective compared with no screening.✓ Nonendoscopic swallowed capsule sponge + biomarker-based strategies were the favorable strategies in both GERD-based and GERD-independent scenarios compared with other endoscopic BE screening modalities."

"Financial support: This work was partially supported by grants from the National Cancer Institute (CA241164 to PGI and JBK, U01CA199336 to JHR), the Department of Veterans Affairs (I01-CX000899 to JHR), and the Freeman Foundation."