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Esophageal Cancer: Diagnosis

How is esophageal cancer diagnosed?

If your healthcare provider thinks you have esophageal cancer, you’ll need tests. Diagnosing this cancer starts with your healthcare provider asking you questions. He or she will ask you about your health history, symptoms, risk factors, and family history of disease. He or she will also do a physical exam.

What tests might I need?

You may have one or more of the following tests:

  • Imaging tests. These include a barium swallow (esophagram) and an upper endoscopy (esophagogastroduodenoscopy or EGD).

  • Biopsy. This may be done during an upper endoscopy.

Imaging tests

Barium swallow

For this test, you’ll swallow a chalky liquid. This is called barium. Then your healthcare provider will take a series of X-rays of your esophagus. The barium coats the inside of your esophagus. This makes it easier to see on the X-rays. The X-rays show if part of your esophagus is too narrow or has any other issues that might be due to cancer. A doctor who specializes in X-rays (called a radiologist) views the images. Sometimes this test is done as part of a series of X-rays that includes the stomach and part of the intestine. This is called an upper gastrointestinal (GI) series. 

Used alone, a barium swallow cannot normally diagnose cancer. But it can show abnormal areas that might need to be biopsied.

Upper endoscopy

For this test, your healthcare provider uses a flexible, lighted tube with a video camera on the end. This is called an endoscope. This lets your healthcare provider see the lining of your esophagus. It also shows your stomach and the first part of your small intestine.


Click Image to Enlarge

Before the test, your healthcare provider will spray your throat with a local anesthetic to numb it. You may also get a sedative to help you relax. Your healthcare provider puts the endoscope through your mouth. It goes down your throat into your esophagus. Your healthcare provider sees the picture from the scope on a monitor. These pictures shoe any tissue that isn’t normal. 

An upper endoscopy takes about 30 minutes. You’ll need to stay in the testing area for about one to two hours until the sedative wears off.

This test can confirm if you have cancer in the esophagus. It can also show its size. If cancer is found, you may need other types of tests. These can show how far the cancer has spread.


If needed, your healthcare provider can also insert tools through the endoscope to remove small pieces of tissue for testing. This is called a biopsy. Your healthcare provider sends the tissue to a lab. There, it’s looked at under a microscope by a special doctor called a pathologist. The pathologist can see if cancer is present.

Getting your test results

When your healthcare provider has the results of your tests, he or she will contact you. If cancer is found, your healthcare provider will talk to you about other tests you may need. Make sure you understand your results and what follow-up care you need.


Online Medical Reviewer: Alteri, Rick, MD
Online Medical Reviewer: Gersten, Todd, MD
Last Review Date: 5/1/2016
© 2013 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare provider's instructions.