Tests for oesophageal cancer

There are a number of tests you might have to find out the cause of your symptoms. If you have oesophageal cancer, you usually have further tests to find out how big the cancer is and whether it has spread. This might include all or some of the following:

  • blood tests
  • tests to look inside your food pipe (oesophagus)
  • different types of scans 

You might have some of these tests again during and after treatment.

Tests your GP might do

Most people start by seeing their GP when they have symptoms. Your GP can do some tests to help them decide whether you need a referral to a specialist. They might:

  • do some blood tests
  • feel, look and listen for any changes in your body (physical examination)

Blood tests

Your GP might arrange for you to have blood tests. You usually have these at your GP practice or your local hospital. Blood tests can give an idea of your general health and if certain systems in your body are working normally, such as your liver or kidneys.

Physical examination

Depending on your symptoms your GP might do a general examination. They will feel for any areas that are swollen or might not feel normal. And if you have any pain, they will feel those areas. They also listen to your chest and tummy to find out if it sounds normal. For example they can listen for signs of fluid collecting, or your digestive system working.

Tests your specialist might do

Your GP should arrange for you to see a specialist if you have symptoms that could be due to oesophageal cancer. Or they might refer you straight to the hospital for tests.

The tests you might have include:

  • gastroscopy
  • CT scan
  • endoscopic ultrasound
  • PET-CT scan
  • laparoscopy

Gastroscopy

A gastroscopy is a test that looks at the inside of your oesophagus, stomach and the first part of your small intestine (small bowel). You may also hear this test called an endoscopy or oesophago gastric duodenoscopy (OGD).

The doctor uses a long flexible tube (gastroscope) with a tiny camera and light on the end to look inside your oesophagus. They check the oesophagus for growths or abnormal looking areas.

Diagram of an endoscopy

They will take samples (biopsies) of any abnormal looking tissue and send them to the laboratory. A specialist then examines these samples under a microscope. They decide whether the abnormal looking tissue is cancer and what type of cancer it is. This can help your doctor to plan your treatment. 

CT scan

A CT scan is a test that uses x-rays and a computer to create detailed pictures of the inside of your body. It takes pictures from different angles. The computer puts them together to make a 3 dimensional (3D) image. CT (or CAT) stands for computed (axial) tomography.

The scan looks at your chest, tummy (abdomen) and the area between your hips (pelvis). Doctors can use a CT scan to look for oesophageal cancer. It can help them to:

  • diagnose and stage oesophageal cancer
  • find out exactly where the cancer is in your oesophagus
  • check whether cancer has spread 

You might also have CT scans after your treatment for oesophageal cancer.

Endoscopic ultrasound (EUS)

You might have an endoscopic ultrasound if you have oesophageal cancer. This is to help find out the size of the cancer and if it has spread. 

This test combines ultrasound and endoscopy to look at the areas around your oesophagus and stomach.

To do the test your doctor uses a long flexible tube called an endoscope. It has a tiny camera and light on the end and an ultrasound probe attached. The ultrasound scan uses high frequency sound waves to create a picture of the inside of your body.

They can also take biopsies during this test.

PET-CT scan

A PET-CT scan combines a CT scan and a PET scan. PET stands for positron emission tomography. The PET scan uses a mildly radioactive drug to show up areas of your body where cells are more active than normal.

The CT scan takes a series of x-rays from all around your body and puts them together to create a 3 dimensional (3D) picture.

You have a PET-CT scan to find out more about where exactly your oesophageal cancer is and if it has spread. It will help your doctors decide what treatment you need.

Laparoscopy

Your doctor might decide you need a laparoscopy. This is a small operation to look inside your abdomen. Doctors use it to find out if cancer of the oesophagus has spread and to help plan your treatment.

Your surgeon puts a thin tube with a light and a camera (laparoscope) through a small cut in your abdomen. They check the area around the oesophagus and take tissue samples (biopsies).

You’re more likely to have a laparoscopy if the cancer is low down in your oesophagus, near where it joins the stomach.

Treatment

The tests you have help your doctor find out if you have oesophageal cancer and how far it has grown. This is the stage of the cancer. 

This is important because doctors recommend your treatment according to the stage of the cancer.

  • Referral Guidelines for suspected cancer
    National Institute for Health and Care Excellence (NICE), 2015 (updated 2021)

  • Oesophageal cancer: ESMO clinical practice guideline for diagnosis, treatment and follow up
    R Obermannova and others
    Annals of Oncology (2022). Volume 33. Pages 992-1004

  • Recommendations for cross-sectional imaging in cancer management (2nd Edition)
    The Royal College of Radiologists, 2014

  • Oesophago-gastric cancer: assessment and management in adults
    National Institute for Health and Care Excellence (NICE), January 2018

  • ECCO essential requirements for quality cancer care: Oesophageal and gastric cancer
    W Allum and others
    Critical Reviews in Oncology / Haematology, 2018. Volume 122. Pages 179-193

Last reviewed: 
23 Aug 2023
Next review due: 
24 Aug 2026

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