The Validity of Barium Swallow in the Diagnosis of Head and Neck Cancer Patients

Globus pharyngeus is a common benign condition. Patients with this condition are commonly investigated to exclude the risk of upper aero-digestive malignancies. One of the investigations carried out is barium swallow. However, there is great debate regarding the role of barium swallow in the diagnosis of head and neck cancers. Therefore, the aim of this audit is to review the validity of barium swallow in diagnosing malignancies amongst patients with globus. Data retrieved from the Head and Neck service in Ysbyty Gwynedd reviews all patients diagnosed with head and neck cancer in Betsi Cadwaladr Health Board, which covers all North West Wales in the period between January 2010 and December 2014. Results show that out of 708 patients, barium swallow suspected malignancy in 5 patients. Therefore, the audit confirms that that barium swallow has a very limited sensitivity and specificity in diagnosing head and neck cancer. In conclusion, barium swallow should not be requested routinely as part of the management of globus pharyngeus patients, as it is not. This approach will reduce the cost and radiation effect of unnecessary investigations.