The following signs and symptoms should be investigated promptly, particularly where there is new onset or changes in long-term symptoms:

• dysphagia (difficulty swallowing, especially bread or meat)
• persistent epigastric pain/dyspepsia
• pain on swallowing
• food bolus obstruction
• unexplained weight loss or anorexia
• haematemesis (vomiting blood) or melena
• early satiety
• unexplained persistent nausea/bloating or anaemia.

The following symptoms are particularly concerning (red flag) and require urgent consultation:

• new-onset or rapidly progressive dysphagia
• progressive/new epigastric pain persisting for more than two weeks.

The presence of multiple signs and symptoms, particularly in combination with other underlying risk factors, indicates an increased risk of oesophagogastric cancer.