I appreciate the opportunity to comment on the article by Agrawal and Wenig addressing the relative merits of radiological vs endoscopic evaluation of the esophagus in search for a simultaneous second primary tumor in patients with head and neck cancer. While dynamic imaging using contrast material does provide a substantial amount of information relative to esophageal function as well as variations in anatomy, this study is less helpful than direct visualization when searching for the second primary tumor. As a rule, swallowing disorders are best evaluated using cineoesophagraphy and/or esophagography and mucosal lesions are best evaluated using the endoscope.