The incidence of esophageal adenocarcinoma (EAC) has increased six-fold since 1979, making it the fastest-growing cancer in the United States. EAC is often diagnosed at a symptomatic stage, resulting in a five-year survival rate of less than 20%. Barrett’s esophagus (BE) – the condition where the normal squamous epithelium of the distal esophagus is replaced by columnar metaplasia – is recognized as the precursor lesion for EAC. This study aims to extend existing guidelines to include a population that is currently underrepresented in the evidence base, providing clinicians with a reliable, quantitative, evidence-based model for managing incidentally detected BE in young patients.