Endoscopic Esophageal Screening for Patients at High Risk

Esophageal squamous-cell carcinoma accounts for about half of all esophageal cancers. Particular risk factors for esophageal cancer include history of head or neck cancer or of pulmonary squamous-cell cancer. Unfortunately, no consensus guidelines exist for screening or surveillance of high-risk patients. Recent advances in chromoendoscopy point to its potential adjunctive value (over endoscopy alone) for identifying dysplasia and early esophageal cancers. Lugol stain, which is iodine-based, is of particular interest for this use in these patients: The chemical reaction that occurs between iodine and glycogen in normal epithelial cells does not occur in dysplastic and cancerous cells because they are “immature” and, thus, glycogen-poor.

In a…