This paper examines three varied ways in which the notion of overdiagnosis has been employed in literature on Barrett’s oesophagus (BO). It argues that the term has been poorly defined and calls for greater clarity in its usage in the future.

BO is a metaplastic change in the lining of the oesophagus in which normal squamous epithelium is replaced by specialised or intestinalised columnar epithelium. It is often described as a precancer or risk factor for oesophageal adenocarcinoma—a type of cancer that has poor survival rates. In the UK's National Health Service (NHS), those diagnosed with BO are offered regular and sometimes lifelong endoscopic surveillance with the aim of detecting and treating dysplasia to prevent the development of cancer. As such, BO may potentially offer an opportunity to facilitate oesophageal cancer prevention and early detection.

In the past decade, several medical societies have suggested screening high-risk populations for BO1–3, with risk factors including include long term GORD symptoms, being over 50, male, white ethnicity, and having a family history of oesophageal adenocarcinoma. In the UK, BO screening does not routinely occur at present. At least in this part, this is because doing so would require the use of endoscopies, which are expensive for healthcare services and can be uncomfortable for patients. Researchers …