Looking for a disease in someone without symptoms is called screening. The goal of screening is to find a disease like cancer in an early, more curable stage, in order to help people live longer, healthier lives.
In the United States, screening the general public for esophageal cancer is not recommended by any professional organization at this time. This is because no screening test has been shown to lower the risk of dying from esophageal cancer in people who are at average risk.
However, people who have a high risk of esophageal cancer, such as those with Barrett’s esophagus, are often followed closely to look for early cancers and pre-cancers.
Testing people at high risk
Many experts recommend that people with a high risk of esophageal cancer, such as those with Barrett’s esophagus, have upper endoscopy regularly. For this test, the doctor looks at the inside of the esophagus through a flexible lighted tube called an endoscope (see “How is cancer of the esophagus diagnosed?”). The doctor may remove small samples of tissue (biopsies) from the area of Barrett’s so that they can be checked for dysplasia (pre-cancer cells) or cancer cells.
Doctors aren’t certain how often the test should be repeated, but most recommend testing more often if areas of dysplasia are found. This testing is repeated even more often if there is high-grade dysplasia (the cells appear very abnormal).
If the area of Barrett’s is large and/or there is high-grade dysplasia, treatment of the abnormal area might be advised because of the high risk that an adenocarcinoma is either already present (but was not found) or will develop within a few years. Treatment options for high-grade dysplasia might include surgery to remove part of the esophagus with the abnormal area, endoscopic mucosal resection (EMR), photodynamic therapy (PDT), and radiofrequency ablation (RFA). These last 3 options are discussed in the “Endoscopic treatments for cancer of the esophagus” section of this document. The outlook for these patients is relatively good after treatment.
Careful monitoring and treatment (if needed) may help prevent some esophageal cancers from developing. It may also detect some cancers early, when they are more likely to be treated successfully.
Last Revised: 02/04/2016