While the risk factors that predispose to esophageal cancer have been identified, the reasons for its increased incidence are still a mystery. Understanding the causes of esophageal cancer and changing some lifestyle habits can reduce the risk of developing the disease.
Esophageal cancer incidence patterns have changed
In 1975, 75% of esophageal cancers in the United States were squamous cell carcinomas. Since then, there has been a major change in the pattern of esophageal cancer:
- The incidence of squamous cell carcinoma has declined slightly.
- The incidence of adenocarcinoma has increased dramatically.
A study published in the Journal of the National Cancer Institute noted that between 1975 and 2001, the incidence of esophageal adenocarcinoma in the United States increased about 6-fold from 4 to 23 per million people, and the mortality rate increased about 7-fold from 2 to 15 per million people. Furthermore, the researchers ruled out the potential for overdiagnosis as a factor in the increased incidence. In other words, the increase in the incidence of esophageal adenocarcinoma in the United States is real and “unadulterated.
Also, according to the National Cancer Institute, adenocarcinoma is the fastest-rising cancer in the United States, with the number of cases already surpassing squamous cancer.
Manjit Bains, a thoracic surgeon at Memorial Sloan-Kettering Cancer Center in New York, said that GERD is a risk factor for adenocarcinoma, and that rising obesity rates may be the primary factor in the increase.
Why is adenocarcinoma “on the rise”?
Why is adenocarcinoma on the rise?
Acid reflux into the esophagus can cause heartburn and indigestion. Almost everyone has experienced this discomfort at some point in their lives, and doctors call it “gastroesophageal reflux disease” (GERD).
The frequent occurrence of acid reflux and heartburn can cause chronic irritation of the esophagus, which can lead to the following problems: the cells of the lower esophagus become morphologically altered due to acid irritation, and the normal squamous epithelium becomes abnormal columnar epithelium, a phenomenon known as “Barrett’s esophagus” (BE). BE).
Patients with Barrett’s esophagus have a 1 in 200 chance of developing adenocarcinoma, which is much higher than the general population.
An interesting set of data regarding Barrett’s esophagus:
- About 5% to 8% of patients with GERD also have Barrett’s esophagus.
- Up to 95% of people with Barrett’s esophagus do not know they have it.
- About 1 in 4 people with Barrett’s esophagus do not have symptoms of acid reflux.
- Although Barrett’s esophagus is closely associated with adenocarcinoma, 90% of patients do not have esophageal cancer.
Esophageal adenocarcinoma, is there a way to detect it early?
The American Gastroenterological Association states that patients with chronic GERD are susceptible to Barrett’s esophagus and should undergo gastrointestinal endoscopy. However, this test requires anesthesia, is more expensive, and carries some risks.
Because of this, the National Cancer Institute recommends against the use of endoscopy in asymptomatic groups.
If you have any of the following possible signs of esophageal cancer and frequent symptoms of acid reflux, you should seek medical attention as soon as possible for reasonable screening:
- Hard or painful swallowing
- Posterior sternal pain
- Cough (sometimes with blood in the sputum coughed up)
- Heartness of voice
- Weight loss (sometimes severe)
- Frequent heartburn or indigestion
What are some good tips for preventing esophageal cancer?
Since esophageal cancer usually spreads before it is detected, prevention is even more important.
- Quit smoking. Quitting smoking will reduce the risk of not only esophageal cancer, but also many other cancers and diseases.
- Limit your alcohol consumption to 1 to 2 drinks per day for men and one drink per day for women.
- Eat plenty of green and yellow vegetables, as well as a variety of fruits.
- Studies have found that taking aspirin or a nonsteroidal anti-inflammatory drug (NSAID) for the treatment of other diseases may reduce the risk of esophageal cancer. However, it is not recommended to take these drugs actively to prevent esophageal cancer.
- Patients with GERD should be screened and treated aggressively. However, the National Cancer Institute states that it is not recommended that any general population go for endoscopic screening, but rather that people at high risk should be screened for reasonable screening at the discretion of their doctor.