Scientists have found strong evidence that Barrett’s oesophagus is the universal precursor to oesophageal adenocarcinoma, one of the most lethal cancers globally. The study, led by researchers at the University of Cambridge and published in Nature Medicine, resolves longstanding uncertainty about how this cancer develops.
Oesophageal adenocarcinoma is often diagnosed at advanced stages, limiting treatment options. While Barrett’s oesophagus has long been linked to the disease, up to half of patients show no visible signs of the condition at diagnosis, raising questions about its role.
Analysing clinical and genomic data from over 3,000 patients, researchers found that tumour DNA and mutation patterns were indistinguishable regardless of whether Barrett’s tissue was detectable. This suggests the precursor may be present but later destroyed as the tumour progresses.
The team also identified biomarkers such as TFF3 and REG4 that persist across disease stages, opening pathways for earlier detection.
The findings could reshape screening strategies, shifting focus toward molecular markers rather than visible symptoms, and improving early diagnosis of a cancer that remains difficult to treat.
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