Panendoscopy: a valuable procedure?

The significance of panendoscopy, performed as part of the routine diagnostic procedure, must be questioned when the incidence of synchronous primary tumors found by this procedure is only 1% to 2%, as in patients with head and neck cancer in the Dutch population. In order to detect a group of patients with a higher probability of secondary tumors, patients were selected for panendoscopy on the following criteria: localization and histology of the index tumors, as well as on smoking and drinking habits. In spite of this selection, the yield of panendoscopy was still below 2%. Until other criteria for the selection of a subset of patients with a high incidence of synchronous tumours are found, the indication for panendoscopy as part of a routine diagnostic procedure has to be constantly questioned, and panendoscopy should therefore be performed only when this procedure is part of a prospective study.