Esophageal cancer screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Hadeel Maksoud M.D.[2]

## Contents

* 1 Overview
* 2 Screening
* 2.1 Adenocarcinoma screening
* 2.2 Squamous cell carcinoma screening
* 3 References

## Overview

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Screening for esophageal cancer has not been established. Screening may be effective in reducing the incidence of esophageal adenocarcinoma, especially in Barrett's esophagus, but is left at the physician's discretion.

## Screening

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### Adenocarcinoma screening

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* The predominant type of esophageal cancer in the United States is adenocarcinoma.[1]
* Since there is a lack of data that records esophageal adenocarcinoma mortality rates, screening is not indicated and is left at the physician's discretion.
* Patients diagnosed with Barrett's esophagus have a higher risk for esophageal adenocarcinoma.
* Screening is therefore recommended for those diagnosed by endoscopy and biopsy for Barrett's esophagus.
* Early screening can detect dysplasias and treatment can be implemented to prevent the incidence of esophageal cancer.
* It should also be noted that those who present with adenocarcinoma demonstrate no prior Barrett's esophagus in 80 - 90% of the time.

### Squamous cell carcinoma screening

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* Screening for squamous cell carcinoma is discouraged in the US because esophageal squamous cell carcinoma carries a very low incidence.[2]
* Squamous cell carcinoma of the esophagus is more prevalent in underdeveloped countries.
* Screening programs are not yet established worldwide.[3]
* A screening program in a high risk population was established in Hishun village, China.
* Those with mild to moderate dysplasia were examined via endoscopy every 3 years, whilst those with severe dysplasia were screened once per year.
* All the patients were concomitantly treated with monoclonal antibodies for the next three years.
* At the end of three year monoclonal antibody trial, the incidence rate of esophageal squamous cell carcinoma had decreased by 57% in comparison to previous incidence rates.
* These results demonstrated that screening for dysplastic changes in the esophagus is effective in the prevention of esophageal squamous cell carcinoma.

## References

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1. ↑ Domper Arnal MJ, Ferrández Arenas Á, Lanas Arbeloa Á (2015). "Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries". World J. Gastroenterol. 21 (26): 7933–43. doi:10.3748/wjg.v21.i26.7933. PMC 4499337. PMID 26185366.
2. ↑ Wang KK, Sampliner RE (2008). "Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett's esophagus". Am. J. Gastroenterol. 103 (3): 788–97. doi:10.1111/j.1572-0241.2008.01835.x. PMID 18341497.
3. ↑ Lin PZ, Zhang JS, Cao SG, Rong ZP, Gao RQ, Han R, Shu SP (1988). "[Secondary prevention of esophageal cancer--intervention on precancerous lesions of the esophagus]". Zhonghua Zhong Liu Za Zhi (in Chinese). 10 (3): 161–6. PMID 3219974.CS1 maint: Unrecognized language (link)

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