Esophageal cancer often has no early stage symptoms. Later stage symptoms include difficulty swallowing and indigestion. Several tests can help diagnose esophageal cancer.

Esophageal cancer is a type of cancer that develops in the esophagus — the long tube that carries food and liquid from your throat to your stomach.

About 21,560 new cases of esophageal cancer are expected to be diagnosed in 2023 in the United States. The disease commonly affects people who smoke, drink heavily, are older, or have Barrett’s esophagus.

Barrett’s esophagus is a precancerous condition that increases the risk of esophageal cancer.

Early on, esophageal cancer usually doesn’t cause any noticeable signs. But as the disease progresses, some common symptoms include:

  • painful swallowing
  • weight loss
  • indigestion
  • coughing

As with most types of cancer, the earlier doctors can diagnose and treat esophageal cancer, the better the outlook. While there aren’t standard early screening tests, several tests can help determine a diagnosis of esophageal cancer.

Healthcare professionals can use everal different types of tests and exams to help them diagnose esophageal cancer.

Barium swallow study

During a barium swallow study, you’ll swallow a liquid that contains a chalky white substance called barium. Then a healthcare professional will take X-rays.

The barium makes it easier for healthcare professionals to view any atypical growths or unusual areas on the X-ray. If anything looks suspicious, your healthcare professional might recommend further testing.


With an endoscopy, a healthcare professional will insert an endoscope down your throat and into your esophagus. An endoscope is a narrow, flexible tube with a small camera and light on the end. There are different types of endoscopy procedures, including:

  • Upper endoscopy: A healthcare professional will pass an endoscope down the throat and into the esophagus while you are sedated. The procedure lets doctors see the lining of the esophagus and look for cancer.
  • Endoscopic ultrasound: It’s often performed at the same time as an upper endoscopy. With an endoscopic ultrasound, a healthcare professional will place a probe that gives off sound waves at the end of the endoscope to create images of tissues. They can also conduct a tissue biopsy or fine needle aspiration at this time.


A biopsy involves removing a small piece of tissue from the esophagus to analyze in the lab for cancer. Typically, a biopsy is the only sure way to confirm a cancer diagnosis. Doctors can perform the biopsy during an endoscopy procedure.

If they detect esophageal cancer with a biopsy, your doctor may order other tests to determine the type of tumor you have and its genetic makeup. This information can help healthcare professionals establish an individualized treatment plan for you.

Other imaging tests

Certain imaging tests may be useful in diagnosing and staging esophageal cancer. For instance, your doctor might recommend a CT scan, MRI scan, or PET scan.

These exams are often performed to determine if esophageal cancer has spread to other areas of the body.

Blood tests

Doctors may order the following blood tests to help diagnose esophageal cancer:

  • Complete blood count (CBC): Some people with esophageal cancer have low red blood cell counts.
  • Liver enzyme tests: Esophageal cancer can spread to the liver, which can affect liver function.
  • Genetic tests: This kind of blood test can identify any genetic mutations commonly associated with esophageal cancer. Additional testing may also help determine effective treatment options.

According to the American Cancer Society, no professional organizations recommend screening the general public for esophageal cancer at this time. But many experts suggest that people who are at high risk of developing the condition should have an endoscopy procedure regularly.

Healthcare professionals often recommend this screening for individuals with Barrett’s esophagus or certain inherited syndromes that put them at risk for esophageal cancer.

If precancerous lesions are found, doctors can treat them and lessen the risk of full-blown esophageal cancer.

Though there’s no specific blood test to definitively diagnose esophageal cancer, some markers can indicate the possibility of the disease.

While it’s uncommon for your doctor to suspect esophageal cancer without the presence of symptoms, certain routine test results may indicate the need for additional testing.

For example, your doctor may request a blood draw to check your CBC count and liver function. If your red blood cell counts are low and your liver enzymes are irregular, your healthcare professional may suspect esophageal cancer.

They will likely need more tests to confirm the diagnosis.

Some common symptoms of esophageal cancer include:

These symptoms may not always indicate cancer, but you should see your doctor if you have any persistent issues.

Several types of tests are used to diagnose esophageal cancer. Your doctor can help determine what exams will be most useful in making a diagnosis. A biopsy is considered the conclusive way to diagnose esophageal cancer.

If you find out you have esophageal cancer, you should know many treatments are available. When esophageal cancer is found early, the outlook is better. That’s why it’s important to report any early symptoms to your healthcare professional as soon as possible.