A Study of Esophageal Cancer Detected by Screening Upper Endoscopy for a Routine Health Check-up

ABSTRACT

BACKGROUND/AIMS: This study was performed to evaluate the extent, diagnostic and therapeutic results of esophageal cancer found by screening upper endoscopy during a routine health check-up. MATERIALS AND METHODS: Among 88,575 subjects presenting for screening upper endoscopy between 2003 and 2011, those with esophageal cancer were extracted using the pathologic results of upper endoscopic biopsy from the esophagus as the final subjects for this study. Wilcoxon rank sum test or Fisher's exact test were used to test statistical differences. RESULTS: A total of 9 patients with esophageal cancer were detected. Seven patients had squamous cell carcinoma and 2 had adenocarcinoma. A depressed mucosal lesion about 1.0 cm size was the most common endoscopic finding of squamous cell carcinoma, however, a polypoid lesion in association with reflux esophagitis was the major finding of adenocarcinoma. Therapeutic data were available in 7 patients. Five squamous cell carcinoma patients were at stage IA, 3 were treated by endoscopic submucosal dissection and 2 by laparoscopic total esophagectomy. Two adenocarcinoma patients, of stage IIB and IIIA respectively, were treated by Ivor Lewis operation. CONCLUSIONS: Our data suggest that screening upper endoscopy during a routine health check-up may enable early detection of esophageal cancer. However, more effort should be given to detect esophageal adenocarcinoma in an earlier stage.