American Board of Internal Medicine (ABIM) Certification Practice Exam

How often should patients with Barrett esophagus and low-grade dysplasia undergo surveillance?

1. Every 1-2 years

2. Every 6-12 months

3. Every 3-5 years

4. Annually

The correct answer is: Every 6-12 months

Patients with Barrett esophagus and low-grade dysplasia should undergo surveillance every 6-12 months. This recommendation is based on the increased risk of progression to higher-grade dysplasia and esophageal adenocarcinoma associated with low-grade dysplasia. Regular surveillance allows for timely identification of any progression, which is crucial because early detection significantly improves management and outcomes. The American College of Gastroenterology guidelines suggest this frequency to ensure that any potential progression to high-grade dysplasia or cancer is caught early. The close monitoring helps practitioners make informed decisions about intervention, including endoscopic therapy or surgery, depending on the findings during surveillance. In contrast, options advocating a longer interval of 1-2 years or 3-5 years may not be aggressive enough, given the significant risk associated with low-grade dysplasia. Annual surveillance may seem appropriate but does not align as well with guidelines that specifically emphasize the need for more frequent monitoring during this particular risk period.