This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
All are true about Barrett's esophagus, EXCEPT: 
Select and explain. 
A. Specialised columnar metaplasia, B. Major risk factor for adenocarcinoma esophagus, C. Screening endoscopy is required in all patients with GERD symptoms, D. Endoscopic biopsy is the gold standard for confirmation
C: Screening endoscopy is required in all patients with GERD symptoms
Answer: C: Screening endoscopy is required in all patients with GERD symptoms 
Explanation: Barrett's Esophagus: 1. Barrett's esophagus is specialized columnar metaplasia that replaces the normal squamous mucosa of the distal esophagus. 2. It is a major risk factor for adenocarcinoma of the esophagus and is readily detected endoscopically. 3. A screening endoscopy for Barrett's esophagus may be considered in patients with a chronic history (>10 year) of GERD symptoms. 4. Endoscopic biopsy is the gold standard for confirmation of Barrett's esophagus. ALSO KNOW: Endoscopic therapies such as endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), photodynamic therapy (PDT), and radiofrequency ablation (RFA) are effective modalities for treatment of high-grade dysplasia and intramucosal cancer in Barrett's esophagus. Ref: Harrison, Edition-18, Page-2419.