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Oesophageal cancer — MCCQE Part 1 MCQ

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EasySwallowing DifficultyOesophageal cancerMCCQE Part 1

A 66-year-old man with smoking and alcohol history has progressive dysphagia from solids to liquids and 9 kg weight loss. Which of the following is the most appropriate next step?

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Correct answer: EArrange urgent upper endoscopy

Arrange urgent upper endoscopy is the single best answer because the age, timing, examination findings and investigations in the vignette fit Oesophageal cancer better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Association of Gastroenterology dysphagia guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Association of Gastroenterology dysphagia guidance