Teaching Points
- Contrast swallow and endoscopy are complementary.
- There is no hard evidence which of these tests should be performed first.
- If there is a high pre-test probability of malignancy, it is reasonable to perform endoscopy first.
- If there is a lower pre-test probability of malignancy, a contrast swallow may be performed first including assessment of the oropharyngeal phase of swallowing dependant on the history.
- A contrast swallow is a good screening test, allowing assessment of strictures, other morphological abnormalities and motility disorders.
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