Achalasia patients with more than 20 years of evolution, enlarged esophagus with 'knees' and with marked retention must be considered to be of high risk for developing cancer. In this group, the surveillance with endoscopy and lugol vital staining or brush cytology is justified. Other common risk factors of esophageal cancer that must be considered are patients aged over 60 years who are smokers and regular consumers of alcohol.
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