Oesophago-gastric cancer: assessment and management in adults

Context

There are around 13,000 new cases of oesophago-gastric cancer diagnosed in England each year. Mortality rates are high, with over 10,000 deaths annually, and over the last 30 years the incidence of these cancers has continued to increase. Early diagnosis remains challenging, and optimising the diagnostic and treatment pathway is essential to improving management and prognosis.

At present there is considerable variation in management and follow-up for people diagnosed with oesophago-gastric cancer. Though there have been recent advances in surgical techniques and chemotherapeutic agents, it is not yet clear how well these compare with standard therapy in terms of improving survival and quality of life.

This guideline covers adults and young people (18 years and over) who are referred to secondary care with suspected oesophago-gastric cancer, or who have newly diagnosed or recurrent disease. It covers areas of uncertainty or variation in practice in relation to diagnosis, staging and management of various aspects of the disease. Although not intended as a comprehensive guide to the treatment of oesophago-gastric cancer, the information and support needs of people affected, organisation of specialist teams, initial assessment of disease and the management of oesophago-gastric cancer in radical and palliative settings are all covered. We have also covered related topics, such as nutritional support.

This guideline aims to help standardise the treatment of oesophago-gastric cancer.