++
For further information, see CMDT Part 41-09: Esophageal Cancer
+++
Essentials of Diagnosis
++
+++
General Considerations
++
++
Occurs usually in persons between 50 and 70 years of age
Ratio of men to women is ∼4:1
About 20,640 new cases of and 16,410 deaths from esophageal cancer in 2022
Adenocarcinomas make up the majority of new cases of esophageal cancer in North America as well as Northern and Western European countries
In the United States squamous cell carcinoma is much more common in Black than in White adults
++
Solid food dysphagia (> 90%)
Odynophagia
Significant weight loss
Coughing on swallowing or recurrent pneumonia suggests tracheoesophageal fistula from local tumor extension
Chest or back pain suggest mediastinal extension
Hoarseness suggests recurrent laryngeal nerve involvement
Physical examination often unrevealing
Supraclavicular or cervical lymphadenopathy or hepatomegaly suggests metastatic disease
+++
Differential Diagnosis
++
++
Anemia related to chronic disease or occult blood loss
Elevated aminotransferase or alkaline phosphatase suggest hepatic or bony metastases
Hypoalbuminemia may signal malnutrition
++
+++
Diagnostic Procedures
++