A DNA test for detection of esophageal precancer

What is the EsoGuard® esophageal DNA test?

With ~90% sensitivity and ~99% negative predictive value at detecting Barrett's esophagus1,2,3 and esophageal adenocarcinoma,1,2 the EsoGuard test allows detection of these conditions in a simple office-based procedure without endoscopy.

The assay uses targeted next generation sequencing (NGS) to examine individual DNA molecules for the presence or absence of cytosine methylation at 31 different genomic locations.

Over 90% of Esophageal Adenocarcinoma patients never knew they had treatable Barrett's Esophagus4

Find Barrett's before it progresses

Barrett's esophagus (BE) is the only known precursor of esophageal cancer.5 Barrett's is related to gastroesophageal reflux disease (GERD) which can cause cells in the esophagus to change in an abnormal way that could lead to cancer.

BE itself doesn’t cause symptoms, so many people are unaware that they have the disease and therefore unaware of their risk of developing cancer.

How it Works

Cell Collection

Distal esophageal cells are sampled in a simple office-based procedure and sent to our laboratory.


The EsoGuard Esophageal DNA Test assesses signature epigenetic changes indicative of BE and EAC using advanced molecular diagnostic techniques.


The clinician receives a report with a positive or negative result indicating whether or not epigenetic changes consistent with BE/EAC were detected.

Who is at risk?

The risk of esophageal precancer is highest in patients with gastroesophageal reflux disease (GERD), age over 50, male, white race, obesity, smoking, and a family history of esophageal precancer (Barrett's esophagus) or cancer (esophageal adenocarcinoma).5,6 

At least thirty million at-risk individuals with gastroesophageal disease (GERD), also known as chronic heartburn, are recommended for esophageal precancer testing by professional society clinical practice guidelines to prevent highly lethal esophageal cancer. Precancer detection is essential because esophageal cancer survival rates are poor, even when detected at Stage I.

Chronic GERD
Male Sex
White Race
Age Over 50
Family History of Esophageal Precancer or Cancer

The innovative Lucid Diagnostics lab is CLIA certified, CAP Accredited, and licensed by the New York State Department of Health.


Researchers, Physicians, Scientists, Innovators, Educators

EsoGuard was developed through the National Cancer Institute and arose from a collaboration among Case Western Reserve University faculty, including renowned cancer geneticists, a passionate gastroenterologist, and a dedicated pathologist.

Amitabh Chak, MD

Physician, Department of Gastroenterology, University Hospitals Cleveland Medical Center

Professor, Department of Medicine, School of Medicine

Case Western Reserve University

Sandy Markowitz, MD

Physician, Department of Hematology and Oncology

​Ingalls Professor of Cancer Genetics, Department of Medicine, School of Medicine

Case Western Reserve University

Helen Moinova, PhD

Assistant Professor, Case Comprehensive Cancer Center

Case Western Reserve University

Joe Willis, MD

Vice Chairman of Pathology, Clinical Affairs, Laboratory Director, University Hospitals Cleveland Medical Center

​Professor, Department of Pathology, School of Medicine

Case Western Reserve University

Ready to start screening with the EsoGuard test?
Get Started
Download the EsoGuard Test Requisition Form
1. Moinova, Helen R et al. “Multicenter, prospective trial of non-endoscopic biomarker-driven detection of f Barrett’s Esophagus and Esophageal Adenocarcinoma.” The American Journal of Gastroenterology (2024): 10-14309.
2. Greer, Katarina B et al. “Non-endoscopic screening for Barrett’s Esophagus and Esophageal Adenocarcinoma in at risk veterans.” medRxiv (2024): 2024-03 [Preprint.
3. Shaheen, N., et al., Use of the EsoGuard® Molecular Biomarker Test in Non-Endoscopic Detection of Barrett's Esophagus among High-Risk Individuals in a Screening Population. medRxiv, 2024: p. 2024.06.24.24309401.
4. Gut 2015 Jan;64(1):20-5. doi: 10.1136/gutjnl-2013-305506. Epub 2014 Apr 3.
5. Shaheen, Nicholas J et al. “Diagnosis and Management of Barrett’s Esophagus: An Updated ACG Guideline.” The American journal of gastroenterology vol. 117,4 (2022):559-587.
6. Muthusamy, V Raman et al. “AGA Clinical Practice Update on New Technology and Innovation for Surveillance and Screening in Barrett’s Esophagus: Expert Review.” Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association vol. 20,12 (2022): 2696-2706.e