Screening Patients With Head and Neck Cancer for Esophageal Cancer
A Lack of Adequate Data
Arch Otolaryngol Head Neck Surg. 1998;124:933.
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An implicit assumption underlying the efficacy of screening patients with head and neck cancer for esophageal carcinoma is that early detection will lead to a more favorable prognosis. As summarized by Agrawal and Wenig, esophagoscopy with or without mucosal iodine staining appears to have a greater sensitivity than esophagography in detecting early esophageal carcinomas. However, despite the compelling notion that survival will improve if a greater number of potentially curable esophageal carcinomas are detected, no study has yet examined whether patients with simultaneous tumors have an increased survival rate if the second tumor is detected with routine screening instead of later when it becomes symptomatic. Likely for this reason, the clinical practice guidelines published by the American Society for Head and Neck Surgery and the Society for Head and Neck Surgeons do not recommend routine esophageal screening, either with esophagoscopy or esophagography in asymptomatic patients. As shown in a recent . . . [Full Text of this Article]
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