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ESCEND aims to shift the paradigm in EC early diagnosis and enhance current endoscopic performance by adding highly sensitive and quantitative fluorescence molecular endoscopy (FME) in real time. Based on exciting preliminary data using fluorescent agents targeting dysplasia and neoplasia and approved for experimental clinical use, ESCEND will advance evidence on minimally invasive FME, which is on the verge of clinical translation and with immense clinical impact and commercialization potential. FME promises to detect disease earlier, with higher specificity and sensitivity, and stratify disease in terms of cancer progression over the current state of the art. Thus, a central ambition of ESCEND is that a hybrid white-light and fluorescence endoscope will become the new BE diagnostic standard.