How is esophageal cancer diagnosed?

Frequent acid reflux over time can lead to esophageal cancer. In this video, John Bagnato, MD, of Coliseum Medical Centers, explains how doctors use technology to make a diagnosis of esophageal cancer.
Upper gastrointestinal cancers, such as esophageal cancer, are a major health burden, with esophageal cancer the eighth most common cancer worldwide. For diagnosis, barium studies may help, but the primary recommendation is flexible endoscopy with biopsy.
If you have a symptom that suggests esophageal cancer, your doctor must find out whether it's really due to cancer or to some other cause. The doctor gives you a physical exam and asks about your personal and family health history. You may have blood tests. You also may have:
  • Barium swallow: After you drink a barium solution, you have x-rays taken of your esophagus and stomach. The barium solution makes your esophagus show up more clearly on the x-rays. This test is also called an upper GI series.
  • Endoscopy: The doctor uses a thin, lighted tube (endoscope) to look down your esophagus. The doctor first numbs your throat with an anesthetic spray, and you may also receive medicine to help you relax. The tube is passed through your mouth or nose to the esophagus. The doctor may also call this procedure upper endoscopy, EGD, or esophagoscopy.
  • Biopsy: Usually, cancer begins in the inner layer of the esophagus. The doctor uses an endoscope to remove tissue from the esophagus. A pathologist checks the tissue under a microscope for cancer cells. A biopsy is the only sure way to know if cancer cells are present.
This answer from the National Cancer Institute has been reviewed and/or edited by Dr. William D. Knopf.
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Randall Holcombe, MD
Hematology & Oncology

Esophageal cancer is usually diagnosed by endoscopy and biopsy. A gastroenterologist uses a thin tube which has a camera and light on the end. This tube is placed through the mouth and allows examination of the esophagus and the area where the esophagus and stomach connect. Biopsies can be done through this tube with a special type of forceps.


Tests, physical exams, and gathering of personal and familial medical history are used to diagnose esophageal cancer. X-rays are one test that is used to diagnosis esophageal cancer. A person going through these x-rays will be asked to drink a special liquid prior to the test being performed. This liquid helps the esophagus show up better in the x-rays. Other tests that might be used include endoscopy (a procedure in which a small tube is guided down the throat so a doctor can look for cancer), and biopsy (a procedure in which a doctor collects a tiny piece of the esophagus to look for abnormal cells).

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.