LETTER TO THE EDITOR COMMENT ON: Progression of esophageal atresia associated Barrett's esophagus in adulthood - Is endoscopic surveillance worth it?

jpedsurg.org

We commend Koivusalo et al. for highlighting surveillance endoscopy in esophageal atresia (EA).1 While their study of 71 adults with repaired type C EA identified increasing rate of Barrett’s esophagus with age and zero cases of adenocarcinoma, their recommendation against surveillance before age 50 warrants caution. This conclusion, based on a small retrospective cohort and absence of adenocarcinoma, contrasts with reports of esophageal adenocarcinoma in EA patients as young as 20 years.2

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Article · Apr 2026 · 1 min read

In brief

This letter challenges recommendations against endoscopic surveillance before age 50 in adults with repaired esophageal atresia. The authors cite reports of adenocarcinoma in EA patients as young as 20, arguing that small cohort size and absence of cancer cases may not justify delaying surveillance given known malignancy risk.

Barrett's esophagus incidence increases with age in adults with repaired esophageal atresia, requiring long-term monitoring considerations.
Esophageal adenocarcinoma has been reported in EA patients as young as 20 years, challenging delayed surveillance recommendations.
Small retrospective cohorts may underestimate malignancy risk; absence of cancer in 71 patients doesn't justify deferring surveillance to age 50.
Surveillance endoscopy timing in repaired EA remains controversial and requires individualized risk assessment beyond age-based protocols.

Written by the GCMD Library team from the article.

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