Esophageal Cancer

Abstract

In 2011, approximately 17,000 new cases of esophageal cancer were diagnosed in the United States and 15,000 died from this disease. Five-year survival is estimated at 17 %, increased from 5 % in the 1970s. The average age of diagnosis is 68. The two major histologic types are squamous cell carcinoma (SCC) and adenocarcinoma. The highest incidence rates are found in the “esophageal cancer belt” of Asia, Africa, and Iran. In these areas, 90 % of cases are squamous cell carcinoma, whereas in the United States, adenocarcinoma is more prevalent. Men are eight times more often affected than women. Risk factors for squamous cell carcinoma include smoking, alcohol abuse, foods containing N-nitroso compounds, drinking hot tea, achalasia, tylosis, and a history of caustic esophageal injury in childhood. The predominant risk factor for adenocarcinoma is Barrett’s esophagus (30-fold increased risk), which is intestinal metaplasia that occurs as a result of long-standing gastroesophageal reflux disease (GERD).