SIGNIFICANCE OF ROUTINE ANNUAL ESOPHAGRAM FOR EARLY DETECTION OF CARCINOMA OF THE ESOPHAGUS

Background/Aims: In order to achieve increased survival rates for pati ents with carcinoma of the esophagus, early detection of the disease i s vital. Serial esophagrams were evaluated to clarify which interval w ould be effective for early detection, of carcinoma of the esophagus d uring routine examination. Materials and Methods: One hundred eighty-n ine patients with carcinoma of the esophagus were grouped into three, according to the experience and the time of the previous roentgenogram s before the definite diagnosis. Results: Five patients were in Group 1, in which roentgenographic examination had been done within 12 month s prior to the diagnosis. Retrospective observation revealed a slight but certain abnormal shadow at the same Location as the esophageal tum or seen, on the second films. In Group 2, seven had received an esopha gram between 12 and 24 months before the diagnosis. In contrast to Gro up 1, neither abnormality nor findings indicating esophageal tumors we re detected on the former x-ray films, in, all seven, cases. Group 2 w as characterized by relatively small tumors and low stage of the disea se. Mean tumor length was 4.1+/-2.9 cm, and three of seven, were class ified as Stage I and two as Stage IIA. On the other hand, most of the 177 patients in Group 3, with no previous examination of the esophagus within 24 months before the diagnosis, had far advanced disease. Mean tumor length was 6.3+/-2.6 cm. Only nine (5.1 %) were classified as S tage I, whereas 115 (65.0 %) were classified as Stage III or IV. Concl usion: In light of these data, for populations in which esophageal can cer frequently occurs, esophageal examination every 12 months will no doubt contribute towards the early detection of lesions.