B. BACKGROUND AND SIGNIFICANCE Burden of disease Barrett's esophagus (BE) is an acquired condition resulting from chronic gastroesophageal reflux disease and is a well recognized pre-malignant condition for the development of esophageal adenocarcinoma (EAC) (1, 2). BE is defined as the displacement of the squamocolumnar junction proximal to the gastroesophageal junction with the presence of intestinal metaplasia (15). This condition entails a 30 to 50 fold greater risk for the development of EAC and has an incidence of development of EAC that approaches 0.5% annually (3, 4). EAC is a highly lethal cancer and is the most rapidly increasing cancer in the United States and Western Europe with an incremental increase of 4-10% per year. Although survival rates have improved during the recent years in some countries, the overall 5-year survival rate is still a dismal 10% in most Western populations (5-7). Clinical strategies for preventing deaths from this cancer focus on techniques for identification of esophageal neoplasms in an asymptomatic, early, and curable stage. Therefore, endoscopic screening of subjects with chronic reflux symptoms has been recommended as a method of detecting BE and early cancer (8). Patients with BE are then routinely enrolled in surveillance programs in an attempt to identify those who might benefit from treatment at a pre-invasive stage of EAC with an ultimate aim of reducing cancer related deaths (8).