The combination of esophageal biopsy and brushings for cytologic evaluation establishes a diagnosis of carcinoma in 95% of patients with malignant strictures. The barium esophagogram, particularly using air contrast radiographic technique, has enabled the demonstration of lesions as small as 5 to 15 mm in early detection programs. Unfortunately, programs for early detection of esophageal carcinoma using mass screening of patients with barium esophagograms, flexible fiberoptic esophagoscopy, and cytology are not cost effective in Western cultures, where the incidence of this disease is relatively low.

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