How Is Esophageal Cancer Diagnosed?

This content has been reviewed and approved by

Chandra P. Belani, MD
Deputy Director, Penn State Cancer Institute
Miriam Beckner Professor of Medicine
Penn State University School of Medicine

There is no routine screening examination for esophageal cancer, but if you have Barrett's esophagus, your doctor needs to examine you on a regular basis because you are at greater risk for developing the disease.

In addition to a complete medical history and physical examination, diagnostic procedures for esophageal cancer may include the following:

• Chest x-ray
• Upper GI (gastrointestinal) series (also called barium swallow) - a diagnostic test that examines the esophagus, stomach, and duodenum (the first and smallest section of the small intestine). The x-ray technician gives you a fluid to drink called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an x-ray). The technician then takes x-rays so that a doctor can evaluate the digestive organs.
• Esophagogastroduodenoscopy (also called EGD or upper endoscopy) - a procedure that allows the doctor to examine the inside of the esophagus, stomach, and duodenum. A thin, flexible, lighted tube, called an endoscope, is guided into the mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope allows the doctor to view the inside of this area of the body, as well as to insert instruments through a scope to perform a biopsy (the removal of a sample of tissue) if necessary.
• Computed tomography scan (CT or CAT scan) - diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images, or "slices," of the body—both horizontally and vertically. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. Computed tomography scans are more detailed than general x-rays.
• Endoscopic ultrasound - imaging technique using sound waves to create a computer image of the inside of the esophagus and stomach. The doctor guides the endoscope into the mouth and throat, then into the esophagus and the stomach. As in standard endoscopy, this procedure allows the doctor to view the inside of this area of the body, as well as insert instruments to perform a biopsy.
• Thoracoscopy and laparoscopy - methods allowing the doctor to examine the lymph nodes inside the chest or abdomen with a hollow, lighted tube, and remove these nodes for further testing. Lymph nodes are tiny glands that play an important role in the body’s defense against infection.