A study using an Edinburgh Dsyphagia Score (EDS) > 3.5 to predict likelihood of cancer gave sensitivity, specificity, positive and negative predictive values of 98.4%, 9.3%, 11.8% and 98.0% (1).
In this study three patients with an EDS of 3 (high risk EDS >=3.5) had malignancy:
- unlike the original validation cohort (2), there was no difference in likelihood of malignancy based on level of dysphagia (pharyngeal level dysphagia 11.9% vs mid sternal or lower sternal dysphagia 12.4%)
- peptic stricture was statistically more frequent in those with longer duration of symptoms (> 6 mo, OR 1.2-2.9, <=8 wk 9.8%, 8-26 wk 10.6%, > 26 wk 15.7%, P < 0.05) and over 60 s (OR 1.2-3.0, age < 60 years 6.2%, 60-73 years 10.2%, > 73 years 10.6%, P < 0.05)
Edinburgh Dysphagia Score:
Note that the weight loss was that reported in the last 3 months period (1)
Reference:
- Murray IA et al. Predictive value of symptoms and demographics in diagnosing malignancy or peptic stricture. World J Gastroenterol. 2012 Aug 28; 18(32): 4357-4362.
- Rhatigan E et al. Scoring system to identify patients at high risk of oesophageal cancer.Br J Surg. 2010 Dec; 97(12):1831-7.
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