Diagnosis and therapy of esophageal squamous cell dysplasia and early esophageal squamous cell cancer

Abstract

Esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) comprise the majority of esophageal cancers, and they differ from each other in several aspects. While the incidence of EAC is increasing in the West, ESCC is still the predominant cancer type worldwide. Squamous dysplasia is considered to be a premalignant lesion to ESCC; however, the exact probability and timeline of malignant transformation are not known, hence the lack of guidelines for management of such lesions. ESCC carries a poor prognosis if not detected early, so there has been a trend towards early detection and treatment. Diagnostic modalities include endoscopic ultrasound, white light endoscopy, non-endoscopic methods such as biomarkers, etc. Early diagnosis can identify a subset of patients who could benefit from less invasive endoscopic eradication therapies. This review aims to discuss the different modalities for diagnosis and treatment of early esophageal squamous lesions, including the newer endoscopic therapies, and comparison of different techniques.