Abstract
Barrett's esophagus has been defined conceptually as the condition in which any extent of metaplastic columnar epithelium that predisposes to cancer development replaces the stratified squamous epithelium that normally lines the distal esophagus. The condition develops as a consequence of gastroesophageal reflux disease. Barrett's metaplasia has clinical importance primarily because of its malignant predisposition, and virtually all of the contentious clinical issues in Barrett's esophagus are related in some way to its cancer risk. This article considers some key clinical issues that impact the management of patients with Barrett's esophagus.