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Esophageal cancer: epidemiology, pathogenesis and prevention

Nature Clinical Practice Gastroenterology & Hepatology volume 5, pages 517–526 (2008)Cite this article

Abstract

Esophageal cancer is highly aggressive and is a common cancer both worldwide and in the US. In the past two decades, the incidence and mortality of esophageal cancer in the US have both increased, whereas the incidence and mortality of other cancers have decreased. Although esophageal squamous cell carcinoma and esophageal adenocarcinoma differ in their histology and epidemiologic distribution, some of their risk factors (e.g. dietary deficiencies and tobacco) and underlying mechanisms of carcinogenesis are the same. Intensive research into risk factors combined with the ability to identify precursor lesions (e.g. squamous dysplasia in esophageal squamous cell carcinoma and Barrett's esophagus in esophageal adenocarcinoma) has paved the way for studies of chemoprevention for esophageal cancer, some of which have shown promising results.

Key Points

  • Esophageal cancer is the sixth leading cause of cancer death worldwide and has a poor prognosis

  • Squamous cell carcinoma is the most prevalent esophageal cancer worldwide, but in the US adenocarcinoma represents the majority of esophageal cancer cases

  • The most important risk factor for esophageal adenocarcinoma is Barrett's esophagus.

  • Important risk factors for squamous cell carcinoma include tobacco, alcohol and diets deficient in fruits and vegetables

  • Chemoprevention studies in esophageal cancer, both dietary and pharmacologic show promise but need further study

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Figure 1: Quantile–quantile plot of BMI (kg/m2) for cases and controls by gender and esophageal cancer cell type.

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Acknowledgements

The authors would like to thank Dr Sandy Dawsey and Dr Paul Limburg for their assistance in reviewing this manuscript.

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Authors and Affiliations

  1. SB Umar is a Fellow of Gastroenterology at Mayo Clinic College of Medicine, and DE Fleischer is Professor of Medicine at Mayo Clinic College of Medicine and a Consultant at Mayo Clinic Arizona, Scottsdale, AZ, USA.,

    Sarah B Umar & David E Fleischer

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  1. Sarah B Umar
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Correspondence to Sarah B Umar.

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Umar, S., Fleischer, D. Esophageal cancer: epidemiology, pathogenesis and prevention. Nat Rev Gastroenterol Hepatol 5, 517–526 (2008). https://doi.org/10.1038/ncpgasthep1223

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