Epidemiology of Adenocarcinoma of the Esophagus, Gastric Cardia, and Upper Gastric Third

  • Manuel Vial
  • Luis Grande
  • Manuel PeraEmail author
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 182)


The incidence of adenocarcinoma of the esophagus and esophagogastric junction (gastric cardia) has risen rapidly over the past three decades in the United States and northern Europe. This increase had been most dramatic among White males. The majority of these cancers arise from Barrett’s esophagus. However, less than 10% of the patients with esophageal adenocarcinoma were known to have Barrett’s esophagus before. Current evidence indicates that gastroesophageal reflux and obesity are major risk factors for adenocarcinoma of the esophagus. Abdominal obesity, more prevalent in males, and independent of body mass index, seems to be associated with an increased risk of esophageal adenocarcinoma but not of cardia adenocarcinoma. This observation may explain the high male:female ratio observed in esophageal adenocarcinoma. Tobacco use has also been found as a possible risk factor for adenocarcinoma of the esophagus and gastric cardia. Infection with Helicobacter pylori and the use of nonsteroidal anti-inflammatory drugs might reduce the risk. On the other hand, low intake of fruits, vegetables, and cereal fibers seem to increase the risk of esophageal adenocarcinoma. Currently, there is no evidence that strongly supports any specific strategy to screen a subgroup of the population at risk for adenocarcinoma of the esophagus or esophagogastric junction. Future strategies to decrease obesity and tobacco use might help to reduce the burden of esophageal adenocarcinoma at least partially.


Esophageal Squamous Cell Carcinoma Pylorus Infection Esophageal Adenocarcinoma Reflux Symptom Gastric Cardia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Ahsan H, Neugut AI, Gammon MD (1997) Association of adenocarcinoma and squamous cell carcinoma of the esophagus with tobacco-related and other malignancies. Cancer Epidemiol Biomarkers Prev 6:779–782PubMedGoogle Scholar
  2. Bahmanyar S, Ye W (2006) Dietary patterns and risk of squamous-cell carcinoma and adenocarcinoma of the esophagus and adenocarcinoma of the gastric cardia: a population-based case-control study in Sweden. Nutr Cancer 54:171–178PubMedCrossRefGoogle Scholar
  3. Blot WJ, Devesa SS, Fraumeni JF (1993) Continuing climb in rates of esophageal adenocarcinoma: an update [letter]. JAMA 270:1320PubMedCrossRefGoogle Scholar
  4. Blot WJ, Devesa SS, Kneller RW, Fraumeni JF (1991) Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA 265: 1287–1289PubMedCrossRefGoogle Scholar
  5. Bosetti C, Levi F, Ferlay J, Garavello W, Lucchini F, Bertuccio P, Negri E, La Vecchia C (2008) Trends in oesophageal cancer incidence and mortality in Europe. Int J Cancer 122:1118–1129PubMedCrossRefGoogle Scholar
  6. Botterweck AAM, Schouten LJ, Volovics A, Dorant E, van den Brandt PA (2000) Trends in incidence of adenocarcinoma of the oesophagus and gastric cardia in ten European countries. Int J Epidemiol 29:645–654PubMedCrossRefGoogle Scholar
  7. Brown LM, Devesa SS (2002) Epidemiologic trends in esophageal and gastric cancer in the United States. Surg Oncol Clin N Am 11:235–256PubMedCrossRefGoogle Scholar
  8. Brown LM, Swanson CA, Gridley G, Swanson GM, Schoenberg JB, Greeberg RS, Silverman DT, Pottern LM, Hayes RB, Schwartz AG, Liff JM, Fraumeni JF, Hoover RN (1995) Adenocarcinoma of the esophagus: role of obesity and diet. J Nat Cancer Inst 87:104–109PubMedCrossRefGoogle Scholar
  9. Bytzer P, Christensen PB, Damkier P, Vinding K, Seersholm N (1999) Adenocarcinoma of the esophagus and Barrett’s esophagus: a population-based study. Am J Gastroenterol 94:86–91PubMedCrossRefGoogle Scholar
  10. Cameron AJ (1993) Epidemiologic studies and the development of Barrett’s esophagus. Endoscopy 25:635–636PubMedCrossRefGoogle Scholar
  11. Cameron AJ (1997) Epidemiology of columnar-lined esophagus and adenocarcinoma. Gastroenterology Clin North Am 26:487–494CrossRefGoogle Scholar
  12. Cameron AJ, Kamath PS, Carpenter HC (1997) Prevalence of Barrett’s esophagus and intestinal metaplasia at the esophagogastric junction. Gastroenterology 112:A82Google Scholar
  13. Cameron AJ, Lomboy CT, Pera M, Carpenter HA (1995) Adenocarcinoma of the esophagogastric junction and Barrett’s esophagus. Gastro­enterology 109:1541–1546PubMedCrossRefGoogle Scholar
  14. Cameron AJ, Romero Y (2000) Symptomatic ­gastro-oesophageal reflux as a risk factor for oesophageal adenocarcinoma. Gut 46:754–755PubMedCrossRefGoogle Scholar
  15. Cameron AJ, Zinsmeister AR, Ballard DJ, Carney JA (1990) Prevalence of columnar-lined (Barrett’s) esophagus: comparison of population-based clinical and autopsy findings. Gastroenterology 99:918–922PubMedGoogle Scholar
  16. Carroll KK (1998) Obesity as a risk factor for certain types of cancer. Lipids 33:1055–1059PubMedCrossRefGoogle Scholar
  17. Casson AG, Zheng Z, Porter GA, Guernsey DL (2006) Genetic polymorphisms of microsomal epoxide hydroxylase and glutathione S-transferases M1, T1 and P1, interactions with smoking, and risk for esophageal (Barrett) adenocarcinoma. Cancer Detect Prev 30:423–431PubMedCrossRefGoogle Scholar
  18. Conio M, Cameron AJ, Romero Y, Branch CD, Schleck C, Burgart LJ, Zinsmeister AR, LJr M, GRr L (2001) Secular trends in the epidemiology and outcome of Barrett’s oesophagus in Olmsted County, Minnesota. Gut 48:304–309PubMedCrossRefGoogle Scholar
  19. Corley DA, Kerlikowske K, Verma R, Buffler P (2003) Protective association of aspirin/NSAIDs and esophageal cancer: a systematic review and meta-analysis. Gastroenterology 124:47–56PubMedCrossRefGoogle Scholar
  20. Corley DA, Kubo A, Levin TR, Block G, Habel L, Zhao W, Leighton P, Quesenberry C, Rumore GJ, Buffler PA (2007) Abdominal obesity and body mass index as risk factors for Barrett’s esophagus. Gastroenterology 133:34–41; quiz 311Google Scholar
  21. Corley DA, Kubo A, Zhao W (2008) Abdominal obesity and the risk of esophageal and gastric cardia carcinomas. Cancer Epidemiol Biomarkers Prev 17:352–358PubMedCrossRefGoogle Scholar
  22. Crane LM, Schaapveld M, Visser O, Louwman MW, Plukker JT, van Dam GM (2007a) Oesophageal cancer in The Netherlands: increasing incidence and mortality but improving survival. Eur J Cancer 43:1445–1451PubMedCrossRefGoogle Scholar
  23. Crane SJ, Richard Locke G, III, Harmsen WS, Diehl NN, Zinsmeister AR, Joseph Melton L, III, Romero Y, Talley NJ (2007b) The changing incidence of oesophageal and gastric adenocarcinoma by ­anatomic sub-site. Aliment Pharmacol Ther 25: 447–453Google Scholar
  24. Chalasani N, Wo JM, Waring JP (1998) Racial differences in the histology, location, and risk ­factors of esophageal cancer. J Clin Gastroenterol 26:11–13PubMedCrossRefGoogle Scholar
  25. Chen H, Tucker KL, Graubard BI, Heineman EF, Markin RS, Potischman NA (2002a) Nutrient intakes and adenocarcinoma of the esophagus and distal stomach. Nutr Cancer 42:33–40PubMedCrossRefGoogle Scholar
  26. Chen H, Ward MH, Graubard BI, Heineman EF, Markin RS, Potischman NA (2002b) Dietary patterns and adenocarcinoma of the esophagus and distal stomach. Am J Clin Nutr 75:137–144PubMedGoogle Scholar
  27. Cheng KK, Sharp L, McKinney PA, Logan RF, Chilvers CE, Cook-Mozaffari P, Ahmed A, Day NE (2000) A case-control study of oesophageal adenocarcinoma in women: a preventable disease. Br J Cancer 83:127–132PubMedCrossRefGoogle Scholar
  28. Chow W-H, Blot WJ, Vaughan TL, Risch HA, Gammon MD, Stanford JL, Dubrow R, Schoen­berg JB, Mayne ST, Farrow DA, Ahsan H, West AB, Rotterdam H, Niwa S, Fraumeni JF (1998a) Body mass index and risk of adenocarcinoma of the esophagus and gastric cardia. J Nat Cancer Inst 90:150–155PubMedCrossRefGoogle Scholar
  29. Chow W, Blaser MJ, Blot WJ, Gammon MD, Vaughan TL, Risch HA, Perez-Perez GI, Schoenberg JB, Stanford JL, Rotterdam H, West AB, Fraumeni JF (1998b) An inverse relation between cagA strains of Helicobacter pylory infection and risk of esophageal and gastric cardia adenocarcinoma. Cancer Res 58:588–590PubMedGoogle Scholar
  30. Chow WH, Finkle WD, McLaughin JK, Frankl H, Ziel HZ, Fraumeni JF (1995) The relation of gastroesophageal reflux disease and its treatment to adenocarcinoma of the esophagus and gastric cardia. JAMA 274:474–477PubMedCrossRefGoogle Scholar
  31. Das D, Ishaq S, Harrison R, Kosuri K, Harper E, Decaestecker J, Sampliner R, Attwood S, Barr H, Watson P, Moayyedi P, Jankowski J (2008) Management of Barrett’s esophagus in the UK: overtreated and underbiopsied but improved by the introduction of a national randomized trial. Am J Gastroenterol 103:1079–1089PubMedCrossRefGoogle Scholar
  32. Devesa SS, Blot WJ, Fraumeni JF (1998) Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 83: 2049–2053PubMedCrossRefGoogle Scholar
  33. Dong LM, Kristal AR, Peters U, Schenk JM, Sanchez CA, Rabinovitch PS, Blount PL, Odze RD, Ayub K, Reid BJ, Vaughan TL (2008) Dietary supplement use and risk of neoplastic progression in esophageal adenocarcinoma: a prospective study. Nutr Cancer 60:39–48PubMedCrossRefGoogle Scholar
  34. Edelstein ZR, Farrow DC, Bronner MP, Rosen SN, Vaughan TL (2007) Central adiposity and risk of Barrett’s esophagus. Gastroenterology 133:403–411PubMedCrossRefGoogle Scholar
  35. Eisen GM (2000) The burning issue of chronic gastroesophageal reflux. Ann Intern Med 133: 227–229PubMedGoogle Scholar
  36. Engel LS, Chow WH, Vaughan TL, Gammon MD, Risch HA, Stanford JL (2003) Population attributable risks of esophageal and gastric cancers. J Natl Cancer Inst 95:1404–1413PubMedCrossRefGoogle Scholar
  37. Falk J, Carstens H, Lundell L, Albertsson M (2007) Incidence of carcinoma of the oesophagus and gastric cardia. Changes over time and geographical differences. Acta Oncol 46:1070–1074PubMedCrossRefGoogle Scholar
  38. Farrow DC, Vaughan TL, Sweeney C, Gammon MD, Chow WH, Risch HA, Stanford JL, Hansten PD, Mayne ST, Schoenberg JB, Rotterdam H, Ahsan H, West AB, Dubrow R, Fraumeni JF, Blot W (2000) Gastroesophageal reflux disease, use of H2 receptor antagonist, and risk of esophageal cancer. Cancer Causes Control 11(3):231–238Google Scholar
  39. Freedman ND, Abnet CC, Leitzmann MF, Mouw T, Subar AF, Hollenbeck AR, Schatzkin A (2007) A prospective study of tobacco, alcohol, and the risk of esophageal and gastric cancer subtypes. Am J Epidemiol 165:1424–1433PubMedCrossRefGoogle Scholar
  40. Funkhouser EM, Sharp GB (1995) Aspirin and reduced risk of esophageal carcinoma. Cancer 76:1116–1119PubMedCrossRefGoogle Scholar
  41. Gammon MD, Shoenberg JB, Ahsan H, Risch HA, Vaughan TL, Chow W-H, Rotterdam H, West AB, Dubrow R, Stanford JL, Mayne ST, Farrow DC, Niwa S, Blot WJ, Fraumeni JF (1997) Tobacco, alcohol, and socioeconomic status and adenocarcinomas of the esophagus and gastric cardia. J Nat Cancer Inst 89:1277–1284PubMedCrossRefGoogle Scholar
  42. Gammon MD, Terry MB, Arber N, Chow WH, Risch HA, Vaughan TL (2004) Nonsteroidal anti-­inflammatory drug use associated with reduced incidence of adenocarcinomas of the esophagus and gastric cardia that overexpress cyclin D1: a population-based study. Cancer Epidemiol Bio­markers Prev 13:34–39PubMedCrossRefGoogle Scholar
  43. GOSPE (1991) Barrett´s esophagus: Epidemiological and clinical results of a multicentric survey. Int J Cancer 48:364–368CrossRefGoogle Scholar
  44. Hampel H, Abraham NS, El-Serag HB (2005) Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med 143:199–211PubMedGoogle Scholar
  45. Hansson LE, Sparen P, Nyren O (1993) Increasing incidence of both major histological types of esophageal carcinomas among men in Sweden. Int J Cancer 54:402–407PubMedCrossRefGoogle Scholar
  46. Huang JQ, Subbaramiah S, Chen Y, Hunt RH (1998) Meta-analysis of the relationship between Heli­cobacter pylori seropositivity and gastric cancer. Gastroenterology 114:1169–1179PubMedCrossRefGoogle Scholar
  47. Hur C, Nishioka NS, Gazelle GS (2004) Cost-effectiveness of aspirin chemoprevention for Barrett’s esophagus. J Natl Cancer Inst 96: 316–325PubMedCrossRefGoogle Scholar
  48. Inadomi JM, Sampliner R, Lagergren J, Lieberman D, Fendrick AM, Vakil N (2003) Screening and surveillance for Barrett’s esophagus in high-risk groups: a cost-utility analysis. Ann Intern Med 138:176–186PubMedGoogle Scholar
  49. Jacobsen BK, Njolstad I, Thune I, Wilsgaard T, Lochen ML, Schirmer H (2001) Increase in weight in all birth cohorts in a general population: the Tromso study, 1974-1994. Arch Intern Med 161:466–472PubMedCrossRefGoogle Scholar
  50. Kalish RJ, Clancy PE, Orringer MB, Appleman HD (1984) Clinical epidemiologic and morphologic comparison between adenocarcinomas arising in Barrett’s esophageal mucosa and gastric cardia. Gastroenterology 86:461–467PubMedGoogle Scholar
  51. Kamangar F, Qiao YL, Blaser MJ, Sun XD, Katki H, Fan JH, Perez-Perez GI, Abnet CC, Zhao P, Mark SD, Taylor PR, Dawsey SM (2007) Helicobacter pylori and oesophageal and gastric cancers in a prospective study in China. Br J Cancer 96:172–176PubMedCrossRefGoogle Scholar
  52. Kendall BJ, Whiteman DC (2006) Temporal changes in the endoscopic frequency of new cases of Barrett’s esophagus in an Australian health region. Am J Gastroenterol 101:1178–1182PubMedCrossRefGoogle Scholar
  53. Kubo A, Corley DA (2002) Marked regional variation in adenocarcinomas of the esophagus and the gastric cardia in the United States. Cancer 95:2096–2102PubMedCrossRefGoogle Scholar
  54. Kubo A, Corley DA (2006) Body mass index and adenocarcinomas of the esophagus or gastric cardia: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 15:872–878PubMedCrossRefGoogle Scholar
  55. Kuriyama S, Tsubono Y, Hozawa A, Shimazu T, Suzuki Y, Koizumi Y (2005) Obesity and risk of cancer in Japan. Int J Cancer 113:148–157PubMedCrossRefGoogle Scholar
  56. Lagergren J, Bergström R, Adami HO, Nyrén O (2000a) Association between medications that relax the lower esophageal sphincter and risk for esophageal adenocarcinoma. Ann Intern Med 133:227–229Google Scholar
  57. Lagergren J, Bergström R, Lindgren A, Nyrén O (1999a) Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med 340:825–831PubMedCrossRefGoogle Scholar
  58. Lagergren J, Bergström R, Lindgren A, Nyrén O (2000b) The role of tobacco, snuff and alcohol use in the aetiology of cancer of the oesophagus and gastric cardia. Int J Cancer 85:340–346PubMedCrossRefGoogle Scholar
  59. Lagergren J, Bergstrom R, Nyren O (1999b) Association between body mass and adenocarcinoma of the esophagus and gastric cardia. Ann Intern Med 130:883–890PubMedGoogle Scholar
  60. Lagergren J, Ye W, Bergström R, Nyrén O (2000c) Utility of endoscopic screening for upper gastrointestinal adenocarcinoma. JAMA 284:961–962PubMedCrossRefGoogle Scholar
  61. Larsson SC, Giovannucci E, Wolk A (2006) Folate intake, MTHFR polymorphisms, and risk of esophageal, gastric, and pancreatic cancer: a meta-analysis. Gastroenterology 131:1271–1283PubMedCrossRefGoogle Scholar
  62. Lassen A, Hallas J, de Muckadell OB (2006) Esophagitis: incidence and risk of esophageal adenocarcinoma a population-based cohort study. Am J Gastroenterol 101:1193–1199PubMedCrossRefGoogle Scholar
  63. Levi F, LaVecchia C (1991) Adenocarcinoma of the esophagus in Switzerland (Letter). JAMA 265: 2960PubMedCrossRefGoogle Scholar
  64. Lindblad M, Rodriguez LA, Lagergren J (2005) Body mass, tobacco and alcohol and risk of esophageal, gastric cardia, and gastric non-cardia adenocarcinoma among men and women in a nested case-control study. Cancer Causes Control 16:285–294PubMedCrossRefGoogle Scholar
  65. Lindblad M, Ye W, Lindgren A, Lagergren J (2006) Disparities in the classification of esophageal and cardia adenocarcinomas and their influence on reported incidence rates. Ann Surg 243: 479–485PubMedCrossRefGoogle Scholar
  66. Locke GRI, Talley NJ, Fett SR, Zinsmeister AR, Melton LJI (1997) Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology 112:1448–1456Google Scholar
  67. MacInnis RJ, English DR, Hopper JL, Giles GG (2006) Body size and composition and the risk of gastric and oesophageal adenocarcinoma. Int J Cancer 118:2628–2631PubMedCrossRefGoogle Scholar
  68. Mayne ST, Navarro SA (2002) Diet, obesity and reflux in the etiology of adenocarcinomas of the esophagus and gastric cardia in humans. J Nutr 132:3467S–3470SPubMedGoogle Scholar
  69. Mehta S, Johnson IT, Rhodes M (2005) Systematic review: the chemoprevention of oesophageal adenocarcinoma. Aliment Pharmacol Ther 22: 759–768PubMedCrossRefGoogle Scholar
  70. Menke-Pluymers MB, Schoute NW, Mulder AH, Hop WC, van Blankenstein M, Tilanus HW (1992) Outcome of surgical treatment of adenocarcinoma in Barrett’s esophagus. Gut 33:1454–1458PubMedCrossRefGoogle Scholar
  71. Menke-Pluymers MBE, Hop WC, Dees J, van Blankenstein M, Tilanus HW (1993) Risk factors for the development of an adenocarcinoma in columnar-lined (Barrett´s) esophagus. Cancer 72:1155–1158PubMedCrossRefGoogle Scholar
  72. Merry AH, Schouten LJ, Goldbohm RA, van den Brandt PA (2007) Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: a prospective cohort study. Gut 56:1503–1511PubMedCrossRefGoogle Scholar
  73. Moller H (1992) Incidence of cancer of the esophagus, cardia and stomach in Denmark. Eur J Cancer Prev 1:159–164PubMedCrossRefGoogle Scholar
  74. Murphy SJ, Anderson LA, Johnston BT, Fitz­patrick DA, Watson PR, Monaghan P, Murray LJ (2005) Have patients with esophagitis got an increased risk of adenocarcinoma? Results from a population-based study. World J Gastroenterol 11: 7290–7295PubMedGoogle Scholar
  75. Navarro Silvera SA, Mayne ST, Risch H, Gammon MD, Vaughan TL, Chow WH, Dubrow R, Schoenberg JB, Stanford JL, West AB, Rotterdam H, Blot WJ, Fraumeni JF Jr (2008) Food group intake and risk of subtypes of esophageal and gastric cancer. Int J Cancer 123:852–860PubMedCrossRefGoogle Scholar
  76. Nguyen AM, Luke CG, Roder D (2003) Comparative epidemiological characteristics of oesophageal adenocarcinoma and other cancers of the oesophagus and gastric cardia. Asian Pac J Cancer Prev 4:225–231PubMedGoogle Scholar
  77. Pandeya N, Williams GM, Sadhegi S, Green AC, Webb PM, Whiteman DC (2008) Associations of duration, intensity, and quantity of smoking with adenocarcinoma and squamous cell carcinoma of the esophagus. Am J Epidemiol 168: 105–114PubMedCrossRefGoogle Scholar
  78. Parsonnet J, Friedman GD, Orentreich N, Vogelman JH (1997) Risk for gastric cancer in people with CagA positive or CagA negative Helicobacter pylori infection. Gut 40:297–301PubMedGoogle Scholar
  79. Pera M (2008) Columnar-lined esophagus: epidemiology and pathophysiology. In: Patterson GA, Deslauriers J et al (eds) Pearson’s thoracic and esophageal surgery, vol 2. Churchill Livingstone, Elsevier, Philadelphia, pp 387–394Google Scholar
  80. Pohl H, Welch HG (2005) The role of overdiagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence. J Natl Cancer Inst 97:142–146PubMedCrossRefGoogle Scholar
  81. Powell J, McConkey CC (1990) Increasing incidence of adenocarcinoma of the gastric cardia and adjacents sites. Br J Cancer 62:440–443PubMedCrossRefGoogle Scholar
  82. Powell J, McConkey CC (1992) The rising trend in esophageal adenocarcinoma and gastric cardia. Eur J Cancer Prev 1:265–269PubMedCrossRefGoogle Scholar
  83. Powell J, McConkey CC, Gillison EW, Spychal RT (2002) Continuing rising trend in oesophageal adenocarcinoma. Int J Cancer 102:422–427PubMedCrossRefGoogle Scholar
  84. Prach AT (1997) Increasing incidence of Barrett´s oesophagus: education, enthusiasm, or epidemiology? Lancet 350:933PubMedCrossRefGoogle Scholar
  85. Provenzale D, Schmitt C, Wong JB (1999) Barrett´s esophagus: a new look at surveillance based on emerging estimates of cancer risk. Am J Gastroenterol 94:2043–2053PubMedCrossRefGoogle Scholar
  86. Rastogi A, Puli S, El-Serag HB, Bansal A, Wani S, Sharma P (2008) Incidence of esophageal adenocarcinoma in patients with Barrett’s esophagus and high-grade dysplasia: a meta-analysis. Gastrointest Endosc 67:394–398PubMedCrossRefGoogle Scholar
  87. Reed PI, Johnston BJ (1993) The changing incidence of oesophageal cancer. Endoscopy 25: 606–608PubMedCrossRefGoogle Scholar
  88. Reeves GK, Pirie K, Beral V, Green J, Spencer E, Bull D (2007) Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ 335:1134PubMedCrossRefGoogle Scholar
  89. Ries L, Melbert D, Krapcho M, Stinchcomb D, Howlader N, Horner M, Mariotto A, Miller B, Feuer E, Altekruse S, Lewis D, Clegg L, Eisner M, Reichman M, Edwards B (2007) SEER Cancer Statistics Review, 1975–2005, National Cancer Institute. Bethesda, MD. In, vol 2008Google Scholar
  90. Rogers EL, Goldkind SF, Iseri OA, Bustin M, Goldkin L, Hamilton SR, Smith RRL (1986) Adenocarcinoma of the lower esophagus. A disease primarily of white men with Barrett´s esophagus. J Clin Gastroenterol 8:613–618PubMedCrossRefGoogle Scholar
  91. Rudolph RE, Vaughan TL, Kristal AR, Blount PL, Levine DS, Galipeau PC (2003) Serum selenium levels in relation to markers of neoplastic progression among persons with Barrett´s esophagus. J Natl Cancer Inst 95:750–757PubMedCrossRefGoogle Scholar
  92. Ryan AM, Rowley SP, Fitzgerald AP, Ravi N, Reynolds JV (2006) Adenocarcinoma of the oesophagus and gastric cardia: male preponderance in association with obesity. Eur J Cancer 42:1151–1158PubMedCrossRefGoogle Scholar
  93. Samanic C, Gridley G, Chow WH, Lubin J, Hoover RN, Fraumeni JFJ (2004) Obesity and cancer risk among white and black United States veterans. Cancer Causes Control 15:35–43PubMedCrossRefGoogle Scholar
  94. Shaheen NJ, Crosby MA, Bozymski EM, Sandler RS (2000) Is there publication bias in the reporting of cancer risk in Barrett’s esophagus? Gastroen­terology 119:333–338PubMedCrossRefGoogle Scholar
  95. Shklar G (1998) Mechanisms of cancer inhibition by anti-oxidant nutrients. Oral Oncol 34:24–29PubMedCrossRefGoogle Scholar
  96. Spechler SJ (2000) Barrett´s esophagus: An overrated cancer risk factor. Gastroenterology 119:587–589PubMedCrossRefGoogle Scholar
  97. Spechler SJ, Goyal RK (1996) The columnar-lined esophagus, intestinal metaplasia, and Norman Barrett. Gastroenterology 110:614–621PubMedCrossRefGoogle Scholar
  98. Takesaki T, Gao CM, Wu JZ, Ding JH, Liu YT, Zhang L (2001) Dietary protective and risk factors for esophageal and stomach cancers in a low-epidemic area for stomach cancers in Jiangsu province, China: comparison with those in a high-epidemic area. Jpn J Cancer Res 92:1157–1165CrossRefGoogle Scholar
  99. Terry P, Lagergren J, Wolk A, Nyren O (2000a) Reflux-inducing dietary factors and risk of adenocarcinoma of the esophagus and gastric ­cardia. Nutr Cancer 38:186–191PubMedCrossRefGoogle Scholar
  100. Terry P, Lagergren J, Ye W, Nyrén O, Wolk A (2000b) Antioxidants and cancers of the esophagus and gastric cardia. Int J cancer 87:750–754PubMedCrossRefGoogle Scholar
  101. Terry P, Lagergren J, Ye W, Wolk A, Nyrén O (2001) Inverse association between intake of cereal fiber and risk of gastric cardia cancer. Gast­roenterology 120:387–391PubMedCrossRefGoogle Scholar
  102. Trivers KF, Sabatino SA, Stewart SL (2008) Trends in esophageal cancer incidence by histology, United States, 1998-2003. Int J Cancer 123:1422–1428PubMedCrossRefGoogle Scholar
  103. van Blankenstein M, Looman CWN, Johnston BJ, Caygill CPJ (2005) Age and sex distribution of the prevalence of Barrett´s esophagus found in a primary referral endoscopy center. Am J Gastroenterol 100:568–576PubMedCrossRefGoogle Scholar
  104. Van der Burgh A, DEES J, WCJ HOP, van Blankenstein M (1996) Oesophageal cancer is an uncommon cause of death in patients with Barrett´s esophagus. Gut 39:5–8PubMedCrossRefGoogle Scholar
  105. van Soest EM, Dieleman JP, Siersema PD, Sturkenboom MC, Kuipers EJ (2005) Increasing incidence of Barrett’s oesophagus in the general population. Gut 54:1062–1066PubMedCrossRefGoogle Scholar
  106. Vaughan TL, Dong LM, Blount PL, Ayub K, Odze RD, Sanchez CA, Rabinovitch PS, Reid BJ (2005) Non-steroidal anti-inflammatory drugs and risk of neoplastic progression in Barrett’s oesophagus: a prospective study. Lancet Oncol 6:945–952PubMedCrossRefGoogle Scholar
  107. Vaughan TL, Kristal AR, Blount PL, Levine DS, Galipeau PC, Prevo LJ, Sanchez CA, Rabinovitch PS, Reid BJ (2002) Nonsteroidal anti-inflammatory drug use, body mass index, and anthropometry in relation to genetic and flow cytometric abnormalities in Barrett’s esophagus. Cancer Epidemiol Biomarkers Prev 11:745–752PubMedGoogle Scholar
  108. Veugelers PJ, Porter GA, Guernsey DL, Casson AG (2006) Obesity and lifestyle risk factors for gastroesophageal reflux disease, Barrett esophagus and esophageal adenocarcinoma. Dis Esophagus 19:321–328PubMedCrossRefGoogle Scholar
  109. Vizcaino AP, Moreno V, Lambert R, Parkin DM (2002) Time trends of both major histologic types of esophageal carcinomas in selected countries. Int J Cancer 99:860–868PubMedCrossRefGoogle Scholar
  110. Wang HH, Antonioli DA, Goldman H (1986) Comparative features of esophageal and gastric adenocarcinomas: recent changes in type and frequency. Hum Pathol 17:482–487PubMedCrossRefGoogle Scholar
  111. Wei WQ, Abnet CC, Qiao YL, Dawsey SM, Dong ZW, Sun XD (2004) Prospective study of selenium concentrations and esophageal and gastric cardia cancer, heart disease, stroke, and total death. Am J Clin Nutr 79:80–85PubMedGoogle Scholar
  112. Whiteman DC, Sadeghi S, Pandeya N, Smithers BM, Gotley DC, Bain CJ, Webb PM, Green AC (2008) Combined effects of obesity, acid reflux and smoking on the risk of adenocarcinomas of the oesophagus. Gut 57:173–180PubMedCrossRefGoogle Scholar
  113. Wu AH, Crabtree JE, Bernstein LA, Hawtin P, Cockburn M, Tseng CC, Forman D (2003a) Role of Helicobacter pylori CagA+ strains and risk of adenocarcinoma of the stomach and esophagus. Int J Cancer 103:815–821PubMedCrossRefGoogle Scholar
  114. Wu AH, Tseng CC, Bernstein L (2003b) Hiatal hernia, reflux symptoms, body size, and risk of esophageal and gastric adenocarcinoma. Cancer 98:940–948PubMedCrossRefGoogle Scholar
  115. Wu AH, Tseng CC, Hankin J, Bernstein L (2007a) Fiber intake and risk of adenocarcinomas of the esophagus and stomach. Cancer Causes Control 18:713–722PubMedCrossRefGoogle Scholar
  116. Wu AH, Wan P, Bernstein LA (2001) A multiethnic population-based study of smoking, alcohol and body size and risk of adenocarcinomas of the stomach and esophagus (United States). Cancer Causes Control 12:721–732PubMedCrossRefGoogle Scholar
  117. Wu X, Chen VW, Andrews PA, Ruiz B, Correa P (2007b) Incidence of esophageal and gastric cancers among Hispanics, non-Hispanic whites and non-Hispanic blacks in the United States: subsite and histology differences. Cancer Causes Control 18:585–593PubMedCrossRefGoogle Scholar
  118. Yang PC, Davis S (1988) Incidence of cancer of the esophagus in the US by histologic type. Cancer 61:612–617PubMedCrossRefGoogle Scholar
  119. Ye W, Held M, Lagergren J, Engstrand L, Blot WJ, McLaughlin JK, Nyren O (2004) Helicobacter pylori infection and gastric atrophy: risk of adenocarcinoma and squamous cell carcinoma of the esophagus and adenocarcinoma of the gastric cardia. J Natl Cancer Inst 96:388–396PubMedCrossRefGoogle Scholar
  120. Yee YK, Cheung TK, Chan AO, Yuen MF, Wong BC (2007) Decreasing trend of esophageal adenocarcinoma in Hong Kong. Cancer Epidemiol Biomarkers Prev 16:2637–2640PubMedCrossRefGoogle Scholar
  121. Zendehdel K, Nyren O, Luo J, Dickman PW, Boffetta P, Englund A, Ye W (2008) Risk of gastroesophageal cancer among smokers and users of Scandinavian moist snuff. Int J Cancer 122:1095–1099PubMedCrossRefGoogle Scholar
  122. Zhang Z-F, Kurtz RC, Yu G-P, Sun M, Gargon N, Karpeh M, Fein JS, Harlap S (1997) Adeno­carcinomas of the esophagus and gastric cardia: the role of diet. Nutrition and Cancer 27:298–309PubMedCrossRefGoogle Scholar
  123. Zheng T, Mayne ST, Holford TR, Boyle P, Liu W, Chen Y, Mador M, Flannery J (1993) The time trend and age-period-cohort effects on incidence of adenocarcinoma of the stomach in Connecticut from 1955-1989. Cancer 72:330–340PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  1. 1.Section of Gastrointestinal SurgeryHospital Universitari del Mar. IMIM – Hospital del Mar, Universitat Autónoma de BarcelonaBarcelonaSpain

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