Esophageal cancer is a rare cancer that can develop in the tissues of your esophagus. There are no standard early screening tests for people at low risk, but certain symptoms could indicate the need for further evaluation.

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Esophageal cancer occurs when cancerous cells form in the tissues of your esophagus — the tube that carries food and liquids from your mouth to your stomach.

Esophageal cancer is rare in the United States, representing just 1.1% of all new cancer cases each year. It’s more common in Asia and parts of Africa.

People who smoke, have a history of heavy alcohol use, or have a condition called Barrett’s esophagus are at higher risk of esophageal cancer. Men are about three times more likely than women to get this type of cancer.

This cancer does not usually cause symptoms during the early stages, which makes it hard to diagnose early. In the later stages of esophageal cancer, symptoms may include difficulty swallowing, cough, voice changes, and indigestion.

Currently, there’s no standard screening test for esophageal cancer. If you have multiple risk factors, your doctor may recommend that you have an endoscopy every 3–5 years to monitor the cells in your esophagus for signs of cancer.

Esophageal cancer usually doesn’t cause any symptoms in the early stages. Healthcare professionals do not recommend that the general public get screened for this cancer because screening tests haven’t been shown to lower the risk of dying from esophageal cancer in people with low risk.

If you have a family history of certain genetic syndromes or esophageal cancer, your doctor may recommend genetic testing. That’s because some inherited genetic mutations have been associated with an increased risk of esophageal cancer. Depending on the results, your doctor may recommend more frequent upper endoscopy screening.

Early symptoms

The earliest symptom of esophageal cancer is usually difficulty swallowing (dysphagia). This might make you feel like food is caught in your throat. It tends to get worse as the tumor grows.

But trouble swallowing could be a symptom of other conditions, and it often does not mean you have cancer. Talk with your doctor if you’re having difficulty swallowing.

Upper endoscopy

If you’re at a higher risk of esophageal cancer, your doctor may recommend that you have a test called an upper endoscopy every 3–5 years to check for changes in the cells of your esophagus that could indicate cancer.

During an endoscopy, a doctor inserts a flexible tube called an endoscope through your mouth and into your esophagus. At the end of the tube is a small camera that sends images in real time to a monitor. You will be sedated during the test and won’t feel any pain.

If a doctor notices any abnormal areas in your esophagus during the endoscopy, they can remove a small sample and send it to a lab to be checked for dysplasia (precancerous cells) or cancer cells.

Barium swallow

A barium swallow is a type of X-ray test that healthcare professionals use to detect any irregular areas in the lining of the esophagus. A healthcare professional will first ask you to drink a thick liquid called barium, which will coat the walls of your esophagus. Then you’ll undergo an X-ray.

A barium swallow can detect early cancers, which may appear as small, round bumps or flat, raised areas.

Esophageal cancer may not cause symptoms until the tumor has grown large enough to affect eating, swallowing, or digestion.

Symptoms include:

Having one or more of these symptoms does not mean you have cancer, but it could mean you have another condition that needs treatment. Schedule an appointment with your doctor for an evaluation if you have any of these symptoms.

No single blood test or imaging test can detect esophageal cancer.

If your doctor thinks you could have esophageal cancer, they are likely to use the following tests to reach a diagnosis:

  • Upper endoscopy: Your doctor inserts a tiny camera on the end of a flexible tube called an endoscope through your mouth and into your esophagus.
  • Biopsy: Your doctor takes a small sample of the abnormal cells and sends them to a laboratory for testing.

Other tests, such as the following, can help your doctor understand the stage and degree of the cancer and its impact on your health:

  • Complete blood count: This test helps check for anemia caused by a bleeding tumor.
  • Blood tests: These tests can detect elevated liver enzymes, which could mean the cancer has spread to your liver.
  • Genomic testing: Your doctor may order this testing to look for specific DNA changes that could be driving the growth of the tumor. These tests can help your doctor choose the best treatment.
  • Imaging tests: Imaging scans such as a CT scan, PET scan, MRI, and ultrasound can help your doctor assess the size of the tumor and whether the cancer has spread to nearby organs.

A risk factor is anything that increases your chances of developing a condition in your lifetime. Having one or more risk factors for esophageal cancer does not mean you will develop it. Sometimes people who don’t have any risk factors at all get this cancer.

Risk factors for esophageal cancer include:

Esophageal cancer occurs when cancerous cells form in the tissues of your esophagus. It usually does not cause any symptoms in the early stages, but trouble swallowing can sometimes be the first symptom.

If you have a high risk of developing this cancer, your doctor may suggest regular screening tests. Esophageal cancer is very rare in the United States, even among people who have multiple risk factors for it. You can talk with your doctor about any recommended tests that can help with early detection.