筛查是什么？
筛查是在一个人有任何症状之前检查是否患癌。这可以帮助发现早期的癌症。当早期发现不正常的组织或癌症时，它可能更容易治疗。当症状出现的时候，癌细胞可能已经开始扩散。
国际上的经济发达国家，如美国，不倡导在疾病负担低的人群中开展食管鳞癌筛查工作，但针对不同的高危人群也提出了相应的筛查方案，其中在亚洲和非洲人群中推荐40岁后采用内镜下碘染色指示性活检的方法开展筛查。在我国食管癌高发现场开展的大量筛查实践及随访观察研究也支持在食管癌高发区及高危人群中开展食管癌筛查。我国长期食管癌筛查实践与研究结果表明，食管癌的筛查工作适宜在农村食管癌高发区和城市的高危人群中进行。
科学家们正试图更好地了解哪些人更可能患某种癌症。他们也研究我们所做的事情和我们身边的环境，以此来观察它们是否会导致癌症。这些信息帮助医生做出关于哪些人应该进行癌症筛查，采用哪种筛查方法，以及多久进行一次筛查的建议。
你要记住的很重要的一点是，如果医生建议你进行癌症筛查，那也并不一定表示他认为你患有癌症。当你没有癌症症状的时候，你才进行癌症筛查。
如果你的筛查结果显示异常，你可能需要接受更多的检查来确认你是否患了癌症。这些被称为诊断检查。
What is screening?
Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.
Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the things around us to see if they cause cancer. This information helps doctors recommend who should be screened for cancer, which screening tests should be used, and how often the tests should be done.
It is important to remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when you have no cancer symptoms.
If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests.
关于食管癌的基本信息
食管癌是一种食管组织里产生恶性（恶性肿瘤）细胞的疾病。
食管是把食物和液体从咽喉传送到胃部的中空肌肉管道。食管壁由数层组织形成，包括黏膜、肌肉和结缔组织。食管癌开始于食管内膜，随着生长通过其他层向外扩散。
食管和胃是上消化道（消化）系统的一部分。
两种最常见的食管癌以其转变为恶性（癌）细胞的细胞类型来命名：
关于食管癌的更多信息参见以下PDQ概述。
食管癌多见于男性。在中国食管癌也多见于男性。
男性患食管癌的几率大约是女性的三倍。每年都会发现更多的食管腺癌的新发病例，鳞状细胞癌的新发病例却较少。比起白人，食管鳞状细胞癌在黑人身上更常见。食管癌的发病率随年龄的增长而增加。男性患食管癌的几率远远高于女性。在中国，食管鳞状细胞癌更常见。食管癌的发病率随年龄的增长而增加。
吸烟、酗酒、巴雷特食管都会影响患食管癌的风险。
任何能增加发病风险的因素都叫做危险因素。存在危险险因素并不意味着你会患上癌症。没有危险因素也并不意味着你不会患上癌症。认为自己有患癌风险的人应该与医生沟通探讨。
食管鳞癌的危险因素包括：
食管腺癌的危险因素包括：
General Information About Esophageal Cancer
Esophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the esophagus.
The esophagus is the hollow, muscular tube that moves food and liquid from the throat to the stomach. The wall of the esophagus is made up of several layers of tissue, including mucous membrane, muscle, and connective tissue. Esophageal cancer starts in the inside lining of the esophagus and spreads outward through the other layers as it grows.
The esophagus and stomach are part of the upper gastrointestinal (digestive) system.
The two most common types of esophageal cancer are named for the type of cells that become malignant (cancerous):
See the following PDQ summaries for more information about esophageal cancer:
Esophageal cancer is found more often in men.
Men are about three times more likely than women to have esophageal cancer. There are more new cases of esophageal adenocarcinoma each year and fewer new cases of squamous cell carcinoma. Squamous cell carcinoma of the esophagus is found more often in blacks than in whites. The chance of developing esophageal cancer increases with age.
Smoking, heavy alcohol use, and Barrett esophagus can affect the risk of developing esophageal cancer.
Anything that increases the chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor.
Risk factors for squamous cell esophageal cancer include the following:
Risk factors for esophageal adenocarcinoma include the following:
食管癌筛查
筛查指在无症状人群中开展的用于发现不同类型癌症的检查。
科学家们通过研究筛查技术找到危害最小且获益最大的筛查方法。癌症筛查试验的目的也是证实早期检测(在产生症状之前发现癌症)是否有助于延长寿命或降低死于癌症的风险。对于某些类型的癌症，如果能早期发现并治疗，患者康复的机会更高。
对于食管癌并没有标准的或者常规的筛查方法。
尽管食管癌没有标准或常规的筛查方法，但是我们正在采用或研究下列检查方法来进行食管癌的筛查:
食管镜
食管镜检查指在食管内部检查异常部位的过程。食管镜从口腔或者鼻腔插入，然后沿着咽喉进入食管。食管镜是一种薄的，自带光源与镜头的可以用来查看情况的管状仪器。它也可能带有能取出组织样本的工具，随后，用显微镜检查标本是否有癌变。
食管镜检查。从口腔插入一根细而发光的管进入食管检查异常区域。
活检
将取出的细胞或者组织放在显微镜下，由病理科医生来检查是否有癌症的迹象。从食管下端的几个不同区域取活检组织有可能发现早期的巴雷特食管。这项检查可能用于有巴雷特食管危险因素的患者。
刷片细胞学
将细胞从食管内膜刷出，然后放置在显微镜下观察其是否异常的过程。这项检查有可能在食管镜检查过程中进行。
球囊细胞学
通过让病人吞下收缩的球囊从而在食管内膜收集细胞的过程。在病人吞下收缩的球囊后，缓慢充盈球囊，并从食管中拉出。在显微镜下观察气球里的食管细胞是否异常。
染色内镜检查
在食管镜检查过程中将染料喷射进食管内膜的过程。内膜某些区域着色增加可能是早期巴雷特食管的症状。
荧光光谱法
用一种特殊的光去观察食管内膜组织的过程。光探头通过内窥镜照射到食管内膜。然后测量食管内膜细胞发出的光。恶性组织比正常组织发出的光要少。
目前正在开展食管癌筛查技术的临床试验。
有关NCI支持的临床试验的信息，可在NCI的临床试验搜索网页上找到。其他组织支持的临床试验可在ClinicalTrials.gov网站上找到。
Esophageal Cancer Screening
Tests are used to screen for different types of cancer when a person does not have symptoms.
Scientists study screening tests to find those with the fewest harms and most benefits. Cancer screening trials also are meant to show whether early detection (finding cancer before it causes symptoms) helps a person live longer or decreases a person's chance of dying from the disease. For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage.
There is no standard or routine screening test for esophageal cancer.
Although there are no standard or routine screening tests for esophageal cancer, the following tests are being used or studied to screen for it:
Esophagoscopy
A procedure to look inside the esophagus to check for abnormal areas. An esophagoscope is inserted through the mouth or nose and down the throat into the esophagus. An esophagoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
Esophagoscopy. A thin, lighted tube is inserted through the mouth and into the esophagus to look for abnormal areas.
Biopsy
The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. Taking biopsy samples from several different areas in the lining of the lower part of the esophagus may detect early Barrett esophagus. This procedure may be used for patients who have risk factors for Barrett esophagus.
Brush cytology
A procedure in which cells are brushed from the lining of the esophagus and viewed under a microscope to see if they are abnormal. This may be done during an esophagoscopy.
Balloon cytology
A procedure in which cells are collected from the lining of the esophagus using a deflated balloon that is swallowed by the patient. The balloon is then inflated and pulled out of the esophagus. Esophageal cells on the balloon are viewed under a microscope to see if they are abnormal.
Chromoendoscopy
A procedure in which a dye is sprayed onto the lining of the esophagus during esophagoscopy. Increased staining of certain areas of the lining may be a sign of early Barrett esophagus.
Fluorescence spectroscopy
A procedure that uses a special light to view tissue in the lining of the esophagus. The light probe is passed through an endoscope and shines on the lining of the esophagus. The light given off by the cells lining the esophagus is then measured. Malignant tissue gives off less light than normal tissue.
Screening tests for esophageal cancer are being studied in clinical trials.
Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
食管癌筛查的风险
筛查是有风险的。
做出筛查的决定是很困难的。不是所有的筛查都有益， 其中大部分是有风险的。在进行任何癌症筛查前，你可能想要和医生讨论一下筛查内容。了解筛查的风险及该检查是否能够降低死于癌症的风险是非常重要的。
我国的大量科学证据表明，上消化道内镜检查是食管癌筛查的有效手段，而且内镜检查对于食管鳞癌的检出效果优于食管腺癌。因此，上消化道内镜检查是预防食管癌发生的有效方法。
食管癌筛查的风险包括：检出食管癌不一定能够改善健康状况或者帮助患者延长生命。
如果你患有晚期食管癌或者癌细胞已经扩散至身体其他部位时，筛查不一定能够改善你的健康状况或者帮助你延长生命。
有一些癌症不会引发症状或者危及生命，但是如果在筛查时发现癌症，这些癌症可能会得到治疗。比起不治疗，治疗是否能够帮助你延长生命也是未知的，而且治疗癌症可能会有严重的副作用。
假阴性检测结果是有可能存在的。
即使已经患有食管癌，筛查结果也可能显示正常。即使有症状，但检测结果为假阴性（实际上有癌症,但检查结果提示正常即没有癌症）的人，也可能延误就医。
假阳性检测结果是有可能存在的。
即使没患癌症，筛查结果也可能会显示异常。假阳性检测结果（实际上没有癌症,但检查结果提示有癌症）会导致焦虑，随后通常会进行更多的检测（如活检），这也有风险。
检测本身也可能产生副作用。
食管镜检查和活检可能会产生罕见却严重的副作用。这些副作用包括：
Risks of Esophageal Cancer Screening
Screening tests have risks.
Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risks. Before having any screening test, you may want to discuss the test with your doctor. It is important to know the risks of the test and whether it has been proven to reduce the risk of dying from cancer.
The risks of esophageal cancer screening tests include the following:
Finding esophageal cancer may not improve health or help a person live longer.
Screening may not improve your health or help you live longer if you have advanced esophageal cancer or if it has already spread to other places in your body.
Some cancers never cause symptoms or become life-threatening, but if found by a screening test, the cancer may be treated. It is not known if treatment of these cancers will help you live longer than if no treatment were given, and treatments for cancer may have serious side effects.
False-negative test results can occur.
Screening test results may appear to be normal even though esophageal cancer is present. A person who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if there are symptoms.
False-positive test results can occur.
Screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isn't) can cause anxiety and is usually followed by more tests (such as biopsy), which also have risks.
Side effects may be caused by the test itself.
There are rare but serious side effects that may occur with esophagoscopy and biopsy. These include the following:
About This PDQ Summary
About PDQ
Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.
Purpose of This Summary
This PDQ cancer information summary has current information about esophageal cancer screening. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Reviewers and Updates
Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Screening and Prevention Editorial Board.
Clinical Trial Information
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
Permission to Use This Summary
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
The best way to cite this PDQ summary is:
PDQ® Screening and Prevention Editorial Board. PDQ Esophageal Cancer Screening. Bethesda, MD: National Cancer Institute. Updated
Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.
Disclaimer
The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.
Contact Us
More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.
About This PDQ Summary
About PDQ
Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.
Purpose of This Summary
This PDQ cancer information summary has current information about esophageal cancer screening. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Reviewers and Updates
Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Screening and Prevention Editorial Board.
Clinical Trial Information
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
Permission to Use This Summary
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
The best way to cite this PDQ summary is:
PDQ® Screening and Prevention Editorial Board. PDQ Esophageal Cancer Screening. Bethesda, MD: National Cancer Institute. Updated
Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.
Disclaimer
The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.
Contact Us
More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.