Esophageal adenocarcinoma has the fastest growing incidence rate of any cancer 
in the United States, and currently carries a very poor prognosis with 5 years 
relative survival rates of less than 15%. Current curative treatment options are 
limited to esophagectomy, a procedure that suffers from high complication rates 
and high mortality rates. Metaplasia of the esophageal epithelium, a condition 
known as Barrett's esophagus (BE), is widely accepted as the precursor lesion 
for adenocarcinoma of the esophagus. Recently, radio-frequency ablation has been 
shown to be an effective method to treat BE, although there is disagreement as 
to whether radio-frequency ablation should be used to treat all patients with BE 
or whether treatment should be reserved for those at high risk for progressing 
to esophageal adenocarcinoma while continuing to endoscopically survey those 
with low risk. Recent research has been targeted towards identifying those at 
greater risk for progression to esophageal adenocarcinoma so that 
radio-frequency ablation therapy can be used in a more targeted manner, 
decreasing the total health care cost as well as improving patient outcomes. 
This review discusses the current state of the literature regarding risk factors 
for progression from BE through dysplasia to esophageal adenocarcinoma, as well 
as the current need for an integrated scoring tool or risk stratification system 
capable of differentiating those patients at highest risk of progression in 
order to target these endoluminal therapies.