Esophageal Cancer Screening
Esophageal Cancer Screening
Cancer screening means looking for cancer or precancerous changes in people who do not have symptoms. There is currently no routine population-wide screening test for esophageal cancer in the United States. However, people at increased risk may benefit from screening or surveillance for Barrett's esophagus and precancerous changes.
THE BASICS: Routine esophageal cancer screening is not recommended for everyone. Upper endoscopy may be recommended for certain people at increased risk of Barrett's esophagus. People already diagnosed with Barrett's may need periodic endoscopy to look for dysplasia or early cancer.
Is there a screening test for esophageal cancer?
Upper endoscopy is the main procedure used to examine the esophagus for Barrett's esophagus, precancerous changes, and early cancer. However, routine endoscopy is not recommended for everyone because esophageal cancer is relatively uncommon. Instead, doctors identify people who may have a higher risk.
Who may need screening for Barrett's esophagus?
Doctors may consider screening in people with chronic GERD who also have additional risk factors. These can include:
Older age
Male sex
Tobacco history
Excess body weight
Family history of Barrett's esophagus or esophageal adenocarcinoma
Other clinical risk factors
Your doctor can determine whether screening is appropriate based on your overall risk profile.
Surveillance for Barrett's esophagus
If you already have Barrett's esophagus, your doctor may recommend periodic upper endoscopy with biopsies. The timing depends on whether dysplasia is present and how abnormal the cells appear.
What happens if dysplasia is found?
Dysplasia means that cells have developed precancerous abnormalities. Treatment may include:
Endoscopic mucosal resection
Endoscopic submucosal dissection
Radiofrequency ablation
Other endoscopic treatments
Treating high-risk precancerous tissue can significantly reduce the likelihood that it will progress to invasive cancer.
Screening is different from diagnosis
Screening is performed in people who do not have symptoms. If you have progressive difficulty swallowing, painful swallowing, unexplained weight loss, gastrointestinal bleeding, or another concerning symptom, you need a diagnostic evaluation. Do not wait for a routine screening appointment to report concerning symptoms.