Iodine Staining for Early Endoscopic Detection of Esophageal Cancer in Alcoholics

Abstract

Background and Study Aims: A retrospective epidemiological investigation has demonstrated that alcohol abuse is a major risk factor for esophageal cancer. However, prospective endoscopic screening for early detection in heavy drinkers is not available at present.

Patients and Methods: A prospective study was conducted that included 255 alcoholics (aged 52 ± 9 years). The patients were consecutively screened using esophagoscopy with iodine staining and targeted biopsy. The study also explored whether there was a relationship between the amount of alcohol intake and the detection rate of esophageal cancer.

Results: Unstained lesions (larger than 5 mm) were observed on the esophageal wall in 55 patients (21.6 %). Ten patients (3.9 %) with 13 lesions were found to have esophageal cancer of the superficial type, with no symptoms. Cancer invasion was confined to the epithelium in three patients, to the lamina propria in seven, and to the submucosa in three. There was a direct relationship between substantial alcohol intake and the presence of esophageal cancer.

Conclusion: Screening esophagoscopy with iodine staining is very advantageous in detecting esophageal cancer at an early stage.