Esophageal Cancer Screening

To date, none has proved able to reduce esophageal cancer deaths in the general population. There are ways, however, to detect esophageal cancer early in certain high-risk patients.

Winship and the American Cancer Society recommend that people at high risk of developing esophageal cancer have regular endoscopies to check for signs of cancer or dysplasia (precancer). Those at high risk include people who have been diagnosed with:

• Barrett esophagus, a condition in which the lower esophagus becomes damaged from untreated reflux disease.
• Tylosis, a rare inherited disease that causes small growths to develop in the esophagus that often turn cancerous.
• Plummer-Vinson syndrome, which is characterized by webbing in the esophagus that can become cancerous.
• Bloom syndrome, a rare genetic disorder that increases risk for gastrointestinal and other types of cancer.

There are no esophageal cancer screening guidelines for individuals at high risk. Instead, those at high risk should work with their gastroenterologist to determine how often they should receive an endoscopy to check for cancer. People who are determined to be at high risk because of inherited conditions should consider beginning screening with endoscopy at age 20. Those with inherited Barrett esophagus should begin screening at age 40.

Esophagoscopy is a test physicians use to check for abnormal cells in the esophagus. It involves the use of a flexible, lighted probe called an endoscope that is inserted through the mouth and into the esophagus. The procedure is performed under sedation. Using the scope, your physician can examine the lining of the esophagus and collect tissue samples that will then be tested for cancer and dysplasia (precancer).

If dysplasia is diagnosed, doctors at Winship can use advanced endoscopic procedures, such as radiofrequency ablation and photodynamic therapy, to remove the abnormal cells before they develop into cancer. In some cases, endoscopic resection (removal) of tissue impacted by dysplasia is used to prevent esophageal cancer from forming.

Early-stage esophageal cancer does not usually have symptoms. Anyone experiencing the following signs of possible esophageal cancer should talk to their doctor right away:

• Difficulty swallowing
• Chest pain
• Unexplained weight loss
• Hoarseness
• Persistent cough
• Vomiting
• Blood in the stool, which may make it appear black
• Anemia
• Fatigue

These symptoms can be caused by many gastrointestinal diseases, and most people who experience these symptoms do not have esophageal cancer. Still, it’s important to seek a diagnosis right away. The sooner esophageal cancer is diagnosed, the better your prognosis will be.

Researchers at Winship are currently studying the potential of blood-based tests to screen for esophageal and other cancers. Once developed, a blood test could be used to detect esophageal cancer in high-risk individuals at earlier stages.