title: Effect of routine esophageal screening in patients with head and neck cancer.
abstract: OBJECTIVE
  Transnasal esophagoscopy or pandoscopy to conduct a tumor survey is routinely recommended for patients with head and neck squamous cell carcinoma (HNSCC). Despite this recommendation, the effect of routine esophageal screening remains unclear.
  
  
  OBJECTIVE
  To investigate the effect of routine esophageal screening on the detection of second primary esophageal squamous cell carcinoma (ESCC) among patients with HNSCC.
  
  
  METHODS
  Retrospective study at the Academic Institute of Otolaryngology, Kaohsiung, Taiwan.
  
  
  METHODS
  Medical records between January 1, 2004, and December 30, 2010, from 3053 patients with HNSCC were retrospectively reviewed.
  
  
  METHODS
  Patients were divided into 2 groups based on whether or not they had received routine esophageal screening, and the 2 groups were compared.
  
  
  METHODS
  Univariate logistic regression analysis was performed to investigate the odds ratios (ORs) for developing second primary ESCC at different sites. The prevalence and cancer stage of second primary ESCC among these 2 groups were compared using the χ2 test.
  
  
  RESULTS
  The prevalences and ORs of second primary ESCC at different tumor sites were 0.8% (reference) for the oral cavity, 6.2% (OR, 8.35) for the oropharynx, 6.6% (OR, 8.89) for the supraglottis, 8.3% (OR, 11.43) for the transglottis, and 14.2% (OR, 20.83) for the hypopharynx. The prevalence of second primary ESCC among the routine screening group (71 of 1592 [4.5%]) was significantly higher than that among the non-routine screening group (44 of 1461 [3.0%]) (P = .04). Among 115 second primary ESCC cases, patients in the routine screening group were diagnosed at an earlier cancer stage than patients in the non-routine screening group.
  
  
  CONCLUSIONS
  Routine esophageal screening is recommended for patients with HNSCC, especially those with oropharyngeal, supraglottic, transglottic, and hypopharyngeal cancers. Routine esophageal screening can increase the early detection of second primary ESCC.
authors.affiliation: Departments of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Yan-Ye
authors.initials: YY
authors.lastname: Su
authors.forename: Wei-Chih
authors.initials: WC
authors.lastname: Chen
authors.forename: Hui-Ching
authors.initials: HC
authors.lastname: Chuang
authors.forename: Chau-Shiang
authors.initials: CS
authors.lastname: Guo
authors.forename: Yu-Tsai
authors.initials: YT
authors.lastname: Lin
authors.forename: Sheng-Dean
authors.initials: SD
authors.lastname: Luo
authors.forename: Fu-Min
authors.initials: FM
authors.lastname: Fang
authors.forename: Chih-Yen
authors.initials: CY
authors.lastname: Chien
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000453:epidemiology; D016017:Odds Ratio; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology