The role of endoscopy in the assessment and treatment of esophageal cancer

This is one of a series of statements discussing the utilization of GI endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text. In preparing this guideline, a MEDLINE literature search was performed, and additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When little or no data exist from well-designed prospective trials, emphasis is given to results from large series and reports from recognized experts. Guidelines for appropriate utilization of endoscopy are based on a critical review of the available data and expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data appear Clinical consideration may justify a course of action at variance to these recommendations. There are approximately 13,000 cases of esophageal cancer diagnosed annually in the United States and adenocarcinoma of the esophagus has one of the fastest rising incidence rates of any malignaney. While esophageal cancer may be detected during endoscopic surveillance of increased-risk conditions such as Barrett's esophagus, the majority of new cancer diagnoses are made in patients presenting with symptoms and not during surveillance programs. The purpose of this guideline is to provide an updated, practical strategy for the use of endoscopy in the diagnosis, staging, and therapy of esophageal cancer.