Because of its tubular shape and relatively easy access, the esophagus is an organ in which endoscopic biopsy and diagnostic cytologic studies are both easy and accurate.43-45 Unfortunately, by the time the majority of patients with carcinoma of the esophagus seek medical advice, they already have advanced tumor and their prognosis is very poor. Considering the relative ease of the available diagnostic procedures, and the very high detection rate of this combined diagnostic approach, it is obvious that the main problem is not accurate, but early, diagnosis.
However, for the time being, endoscopic biopsy and diagnostic cytologic techniques remain tools of clinical practice rather than of mass screening; it is beyond the scope of this brief review to discuss the reasons involved. Hopefully, wider use of the diagnostic procedures will lead to better therapeutic results and will open the way for improved prognosis to be achieved ultimately by selected