Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- dysphagia
- odynophagia
- weight loss
Risk factors
- male sex
- tobacco use (squamous cell carcinoma)
- alcohol use (squamous cell carcinoma)
- GORD and Barrett's oesophagus (adenocarcinoma)
- hiatus hernia (adenocarcinoma)
- FHx of oesophageal, stomach, oral, or pharyngeal cancer (squamous cell carcinoma)
- low socioeconomic status
- non-white race (squamous cell carcinoma)
- high-temperature beverages and foods (squamous cell carcinoma)
- drinking maté (squamous cell carcinoma)
- low intake of fresh fruit and vegetables
- obesity (adenocarcinoma)
- human papillomavirus (squamous cell carcinoma)
- achalasia (squamous cell carcinoma)
- glyceryl trinitrate, anticholinergics, beta-adrenergics, aminophyllines, benzodiazepines (adenocarcinoma)
- vitamin and mineral deficiencies (squamous cell carcinoma)
- poor oral hygiene
Diagnostic investigations
1st investigations to order
- oesophagogastroduodenoscopy (OGD) with biopsy
- comprehensive metabolic profile
Investigations to consider
- CT thorax and abdomen
- MRI thorax and abdomen
- FDG-PET scan
- endoscopic ultrasound (EUS) ± fine needle aspiration (FNA)
- bronchoscopy ± fine needle aspiration (FNA)
- thoracoscopy and laparoscopy
- pulmonary function tests
- cardiac stress test
- echocardiogram
Treatment algorithm
Contributors
Authors

Cancer Institute of New Jersey System Partnership Leader
Oncology Service Line
Meridian Health
Neptune
NJ
Disclosures
MJK is an author of several references cited in this monograph.

Director
Minimally invasive Thoracic Surgery Meridian Health
Meridian Health System
Red Bank
NJ
Disclosures
GA declares that he has no competing interests.
Peer reviewers
Clinical Reader in Surgery
Nuffield Department of Surgery
University of Oxford
Oxford
UK
Disclosures
PM declares that he has no competing interests.
Assistant Professor of Oncology
Roswell Park Cancer Institute
Buffalo
NY
Disclosures
NIK has received funding for the conduction of clinical trials and associated translational studies from Merck, Pfizer, and Astra-Zeneca. NIK has a grant from the National Comprehensive Cancer Network (from research support by Roche).
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