How many cases of esophageal cancer have you seen cured at any stage? The vast majority of esophageal cancers are squamous cells related to smoking, drinking, etc. In 25 years of primary care practice, I have never seen a case of adenocarcinoma related to reflux and Barrett’s metaplasia. They exist, but they are rare. Unless we are prepared to endoscope all patients that we prescribe or suggest PPI’s for dyspeptic symptoms, they might as well be available OTC.