Evidence support routine surveillance endoscopy for patient with Barrett. Esophagus is mainly from observational studies. This randomized control trial of over 3000 patients randomized patients to either surveillance endoscopy every two years or as needed endoscopy based on symptoms patients were followed for a meeting of 13 years. And on average individuals in the as needed group had not only fewer endoscopy performed at the end of follow up, but they had no change in their rates of cancer rela