Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risks. Before having any screening test, you may want to discuss the test with your doctor. It is important to know the risks of the test and whether it has been proven to reduce the risk of dying from cancer.
The PDQ editorial boards use a ranking system of levels of evidence to help the reader judge the strength of evidence linked to the reported results of a therapeutic strategy. For any given therapy, results of prevention and treatment studies can be ranked on each of the following two scales: (1) strength of the study design and (2) strength of the endpoints. Together, the two rankings provide a measure of the overall level of evidence. Screening studies are ranked on strength of study design alone...
The risks of esophageal cancer screening tests include the following:
Finding esophageal cancer may not improve health or help a person live longer.
Screening may not improve your health or help you live longer if you have advanced esophageal cancer or if it has already spread to other places in your body.
Some cancers never cause symptoms or become life-threatening, but if found by a screening test, the cancer may be treated. It is not known if treatment of these cancers will help you live longer than if no treatment were given, and treatments for cancer may have serious side effects.
False-negative test results can occur.
Screening test results may appear to be normal even though esophageal cancer is present. A person who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if there are symptoms.
False-positive test results can occur.
Screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isn't) can cause anxiety and is usually followed by more tests (such as biopsy), which also have risks.
Side effects may be caused by the test itself.
There are rare but serious side effects that may occur with esophagoscopy and biopsy. These include the following:
A small hole (puncture) in the esophagus.
Problems with breathing.
Passage of food, water, stomach acid, or vomit into the airway.
Severe bleeding that may need to be treated in a hospital.