Endoscopic examination of the upper gastrointestinal tract for the presence of second primary cancers in head and neck cancer patients.

Endoscopic examination of the upper gastro-intestinal tract with Lugol's solution staining was performed on 150 patients with head and neck cancer treated at the Departments of Otolaryngology and Radiology, Osaka University Hospital, between June 1987 and December 1991. Thirteen second primary cancers (11 esophageal and 2 gastric cancers) were found endoscopically, although prior fluoroscopy had found only 4 (3 esophageal and one gastric cancer). All of the 9 second primary cancers which were not detected by fluoroscopy were in the early stage. Both Brinkman's and Alcohol indices of double primary cancer cases were significantly higher than those of single head and neck cancer cases. These results indicate that head and neck cancer patients who smoke and/or drink heavily require thorough examination of their upper gastro-intestinal tract with endoscopy, using Lugol's solution staining, as well as with fluoroscopy.