The principal reason for performing investigations in patients with globus pharyngeus is to
detect a pharyngeal or upper oesophageal malignancy presenting this way. There is
uncertainty regarding both the necessity for investigation in globus patients and the first line
investigation of choice in the screening of such patients. The authors therefore undertook a
retrospective study of 699 patients who presented with globus sensation. Of these, 451
patients (64.5 per cent) had a typical history and in these patients, outpatient examination …

My colleagues and I read with interest the article by Harar et al. 1 in the July 2004 issue of
your journal. We agree with the authors that a policy of not investigating a patient with
globus symptoms could produce significant savings for the health service. However, one
needs to be more vigilant in those patients who are at high risk of developing a cancer, eg
those of a typical age and sex with a history of heavy smoking.We were recently referred a
65-year-old man, who was initially seen by his general practitioner (GP) in August 2004 with …