ESOPHAGEAL CARCINOMA AND ACHALASIA: ANOTHER CALL FOR SCREENING?Achalasia Complicated by Squamous Cell Carcinoma: A Prospective Study in 195 Patients Academic Article uri icon


MeSH Major

  • Carcinoma, Squamous Cell
  • Esophageal Achalasia
  • Esophageal Neoplasms


  • One hundred and ninety‐five patients, 90 male, 105 female, with primary achalasia confirmed by radiography, endoscopy, and manometry, were followed prospectively with endoscopic surveillance for esophageal carcinoma at 3 months, then 1, 2, 4, 7, and 10 yr after pneumatic dilation. Patients were diagnosed between 1973 and 1988. Follow‐up included barium x‐ray and manometry, but only endoscopy is reported. The incidence of squamous cell carcinoma was compared with an age‐ and sex‐matched group. Squamous cell carcinoma was seen in three patients, mean age 68 yr. Carcinoma was seen 5, 19, and 28 yr after development of dysphagia, corresponding to 5, 8, and 4 yr after diagnosis of achalasia. Carcinoma was middle third in all. Although anecdotal, the cases are interesting. Two patients were discovered in the screening protocol, one asymptomatic and one who complained of hoarseness prior to the scheduled endoscopy. Both patients had resectable disease and were alive 3 and 6 yr post‐op, without recurrence. The third refused screening after 1 yr, and developed symptoms 4 yr after dilation. His carcinoma had metastasized, and he died 2 months later. The overall incidence of carcinoma was 3.4/1000 patients per year, compared with 0.104/1000 patients per year in controls, a 33‐fold increase (p < 0.001). Copyright © 1993, Wiley Blackwell. All rights reserved

publication date

  • January 1993



  • Academic Article



  • eng

Digital Object Identifier (DOI)

  • 10.1111/j.1572-0241.1993.tb03036.x

PubMed ID

  • 8480752

Additional Document Info

start page

  • 783

end page

  • 4


  • 88


  • 5