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BOB CAT: A large-scale review and delphi consensus for management of Barrett's esophagus with no dysplasia, indefinite for, or low-grade dysplasia

Nason, Katie S.; Tham, Tony C.K.; Iyer, Prasad G.; Siersema, Peter D.; Meltzer, Stephen J.; Wong, Jennie Y.Y.; Weinberg, David S.; Corley, Douglas A.; Ferguson, Mark K.; Bennett, Cathy; Moayyedi, Paul; Corley, Douglas A; Decaestecker, John; Falck-Ytter, Yngve; Falk, Gary; Vakil, Nimish; Sanders, Scott; Vieth, Michael; Inadomi, John; Aldulaimi, David; Ho, Khek Yu; Odze, Robert; Meltzer, Stephen J; Quigley, Eamonn; Gittens, Stuart; Watson, Peter; Zaninotto, Giovanni; Iyer, Prasad G; Alexandre, Leo; Ang, Yeng; Callaghan, James; Harrison, Rebecca; Singh, Rajvinder; Bhandari, Pradeep; Bisschops, Raf; Geramizadeh, Bita; Kaye, Philip; Krishnadath, Sheila; Fennerty, M. Brian; Manner, Hendrik; Nason, Katie S; Pech, Oliver; Konda, Vani; Ragunath, Krish; Rahman, Imdadur; Romero, Yvonne; Sampliner, Richard; Siersema, Peter D; Tack, Jan; Tham, Tony C K; Trudgill, Nigel; Weinberg, David S; Wang, Jean; Wang, Kenneth; Wong, Jennie Y Y; Attwood, Stephen; Malfertheiner, Peter; MacDonald, David; Barr, Hu...


Katie S. Nason

Tony C.K. Tham

Prasad G. Iyer

Peter D. Siersema

Stephen J. Meltzer

Jennie Y.Y. Wong

David S. Weinberg

Douglas A. Corley

Mark K. Ferguson

Cathy Bennett

Paul Moayyedi

Douglas A Corley

John Decaestecker

Yngve Falck-Ytter

Gary Falk

Nimish Vakil

Scott Sanders

Michael Vieth

John Inadomi

David Aldulaimi

Khek Yu Ho

Robert Odze

Stephen J Meltzer

Eamonn Quigley

Stuart Gittens

Peter Watson

Giovanni Zaninotto

Prasad G Iyer

Leo Alexandre

Yeng Ang

James Callaghan

Rebecca Harrison

Rajvinder Singh

Pradeep Bhandari

Raf Bisschops

Bita Geramizadeh

Philip Kaye

Sheila Krishnadath

M. Brian Fennerty

Hendrik Manner

Katie S Nason

Oliver Pech

Vani Konda

Krish Ragunath

Imdadur Rahman

Yvonne Romero

Richard Sampliner

Peter D Siersema

Jan Tack

Tony C K Tham

Nigel Trudgill

David S Weinberg

Jean Wang

Kenneth Wang

Jennie Y Y Wong

Stephen Attwood

Peter Malfertheiner

David MacDonald

Hugh Barr

Mark K Ferguson

Janusz Jankowski


© 2015 by the American College of Gastroenterology. OBJECTIVES:Barrett's esophagus (BE) is a common premalignant lesion for which surveillance is recommended. This strategy is limited by considerable variations in clinical practice. We conducted an international, multidisciplinary, systematic search and evidence-based review of BE and provided consensus recommendations for clinical use in patients with nondysplastic, indefinite, and low-grade dysplasia (LGD).METHODS:We defined the scope, proposed statements, and searched electronic databases, yielding 20,558 publications that were screened, selected online, and formed the evidence base. We used a Delphi consensus process, with an 80% agreement threshold, using GRADE (Grading of Recommendations Assessment, Development and Evaluation) to categorize the quality of evidence and strength of recommendations.RESULTS:In total, 80% of respondents agreed with 55 of 127 statements in the final voting rounds. Population endoscopic screening is not recommended and screening should target only very high-risk cases of males aged over 60 years with chronic uncontrolled reflux. A new international definition of BE was agreed upon. For any degree of dysplasia, at least two specialist gastrointestinal (GI) pathologists are required. Risk factors for cancer include male gender, length of BE, and central obesity. Endoscopic resection should be used for visible, nodular areas. Surveillance is not recommended for


Nason, K. S., Tham, T. C., Iyer, P. G., Siersema, P. D., Meltzer, S. J., Wong, J. Y., …Rolfe, V. (2015). BOB CAT: A large-scale review and delphi consensus for management of Barrett's esophagus with no dysplasia, indefinite for, or low-grade dysplasia. American Journal of Gastroenterology, 110(5), 662-682.

Journal Article Type Review
Publication Date Jan 1, 2015
Journal American Journal of Gastroenterology
Print ISSN 0002-9270
Electronic ISSN 1572-0241
Publisher Springer Nature [academic journals on]
Peer Reviewed Peer Reviewed
Volume 110
Issue 5
Pages 662-682
Keywords BOBCAT, Delphi consensus, Barrett’s esophagus, dysplasia
Public URL
Publisher URL
Additional Information Additional Information : Vivien Rolfe contributed to this article as a member of the BOB CAT Consortium.
Corporate Creators : BOB CAT Consortium