403 The Edinburgh Dysphagia Score as a Triage Tool for Oesophageal Cancer: How Reliable Is It?

Abstract Aim With rising demand for endoscopy and limited resources, effective triage tools are essential to identify patients at highest risk of oesophageal cancer. The Edinburgh Dysphagia Score (EDS) is a simple, clinically based scoring system designed to aid referral decisions. This study aimed to evaluate the diagnostic utility of the EDS in patients with oesophageal cancer. Method A retrospective cohort study was conducted across a single health board, including all patients diagnosed with oesophageal cancer who presented with dysphagia between January 2017 and December 2022. Electronic health records were reviewed to extract relevant clinical data and calculate the EDS, which incorporates six parameters: age, sex, weight loss, duration of symptoms, localisation of dysphagia, and presence of reflux. Patients were stratified into low-risk (<3.5) and high-risk (≥3.5) groups based on their score. Results A total of 536 patients were diagnosed with oesophageal cancer during the study period, of whom 375 (70%) presented with dysphagia. The majority (283; 75.5%) were referred by general practitioners. Most patients were male (258; 68.8%), with a median age of 71 years (IQR 62–79). Adenocarcinoma was the predominant histological subtype, identified in 231 cases (61.6%). The median EDS was 6.5 (IQR 5–8). Of the cohort, 361 (96.3%) patients had a high-risk EDS, while only 14 (3.7%) patients had low-risk EDS. Conclusions The EDS reliably identified the vast majority of oesophageal cancer patients with dysphagia as high-risk. Its simplicity, clinical relevance, and predictive accuracy support its use as a triage tool to prioritise endoscopy and optimise healthcare resource allocation.