A 62-year-old man has painless, progressive difficulty swallowing solids and 6 kg weight loss. What is the most appropriate action?
Answer and explanation
Correct answer: C. Urgent upper gastrointestinal endoscopy on the cancer pathway
- Step 1: Progressive dysphagia with weight loss is an alarm feature suggesting oesophageal or gastric cancer. Step 2. NICE advises urgent direct-access endoscopy for dysphagia at any age, as it allows biopsy. Answer: Urgent upper gastrointestinal endoscopy on the cancer pathway. Why not the others: Waiting for a PPI trial delays diagnosis. A routine barium swallow lacks biopsy and is not urgent. Reassurance ignores red flag features.
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