Should twin-mode white-light and virtual chromoendoscopy of pre-defined mucosal stations be considered a standard of care for transnasal panendoscopy?

Expeditious diagnosis and confident exclusion of cancer as the cause of patient symptoms is central to achieving the long-term NHS Plan's objective of diagnosing 75% of cancers at an early stage in order to save 55,000 lives a year. 1 For foregut cancers, the principal diagnostic methodology is symptom-directed visualisation of the relevant subset of at-risk mucosal stations between the lips and the second part of the duodenum. In selected cases, mucosal visualisation is supplemented by additional tests like radiological evaluation of swallowing, cross-sectional imaging, and ultrasound scanning. The main diagnostic tools used for mucosal visualisation are flexible outpatients nasendoscopy (FNE), examination of the pharynx, larynx and the proximal oesopahgus under general anaesthesia (Panendoscopy), and OesophagoGastroDuodenoscopy (OGD).