Table 1:

Recommended Screening Guidelines for High Risk Populations

Risk factor	Screening method and duration	Outcome	Level of evidence^20
Head and neck cancer	Endoscopy with Lugol’s or NBI every 6 months to 1 year after completion of therapy for HNSCC, for 10 years	• Detects earlier stage disease • Improved survival • No evidence for cost-effectiveness,	II-III (moderate)
Tylosis	4 quadrant biopsies from proximal, middle, and distal esophagus starting at age 30; repeat every 1–3 years	• Effective for early diagnosis • Only beneficial for Type A (late onset) Tylosis	III-IV (low)
Achalasia	Yearly EGD 10–15 years after disease onset +/− Lugol’s solution	• No evidence for cost effectiveness • Need to screen many patients to detect one cancer	III (low)
Asian or African high-risk populations	One time Lugol’s chromoendoscopy beginning at the age of 40	• Screened groups have lower ESCC incidence and mortality rates	II-III (moderate)
History of caustic esophageal injury	Endoscopy every 2–3 years 10–20 years following the injury	• No evidence for effectiveness	IV (low)

^{^}Levels of evidence: Level I evidence: presence of at least one prospective, randomized, controlled trial, level II evidence: well-designed cohort or case-controlled studies; level III evidence: case series or flawed clinical trials; level IV evidence: opinions of respected authorities or expert committees; level V evidence: insufficient evidence to form any opinions