Epidemiology of esophageal cancer: update in global trends, etiology and risk factors
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CLINICAL REVIEW
Epidemiology of esophageal cancer: update in global trends, etiology and risk factors Dustin J. Uhlenhopp1 · Eric Omar Then2 · Tagore Sunkara3 · Vinaya Gaduputi3,4 Received: 8 July 2020 / Accepted: 2 September 2020 © Japanese Society of Gastroenterology 2020
Abstract Esophageal cancer is the eighth most common type of cancer worldwide and constitutes the sixth leading cause of cancer deaths. It is characterized by its high mortality rate, poor prognosis at time of diagnosis and variability based on geographic location. Present day, the prevalence of esophageal cancer is in transition. Although esophageal squamous cell carcinoma continues to be the most prevalent type worldwide, esophageal adenocarcinoma is quickly becoming the most prevalent type in developed countries. Risk factors for the development of esophageal squamous cell carcinoma include low socioeconomic status, consumption of tobacco, alcohol, hot beverages, and nitrosamines. Additionally, micronutrient deficiencies have also been linked to the development of esophageal squamous cell cancer. These include vitamin C, vitamin E, and folate. With respect to esophageal adenocarcinoma, risk factors include Barrett’s esophagus, gastroesophageal reflux disease, obesity, and tobacco consumption. Screening for esophageal cancer will likely play an essential role in prevention, and consequently, mortality in the future. Present day, there are no established guidelines for esophageal squamous cell cancer screening. Guidelines for esophageal adenocarcinoma are more well established but lack concrete evidence in the form of randomized controlled trials. This review will discuss the epidemiology, risk factors, and current prevention strategies for esophageal cancer in depth. It is our aim to raise awareness on the aforementioned topics to increase public health efforts in eradicating this disease. Keywords Esophageal cancer · Adenocarcinoma · Squamous cell carcinoma · Epidemiology · Mortality
Introduction Cancers of the esophagus account for over 500,000 cancer deaths annually, which is 5.3% of all global cancer deaths and have significant varying distributions worldwide [1]. Esophageal squamous cell carcinoma (ESCC) is the most * Dustin J. Uhlenhopp [email protected] 1
Department of Internal Medicine, MercyOne Des Moines Medical Center, 1111 6th Avenue, Des Moines, IA 50314, USA
2
Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, 121 Dekalb Avenue, Brooklyn, NY 11201, USA
3
Department of Gastroenterology and Hepatology, MercyOne Des Moines Medical Center, 1111 6th Avenue, Des Moines, IA 50314, USA
4
Division of Gastroenterology and Hepatology, SBH Health System, 4422 Third Avenue, Bronx, NY 10457, USA
prevalent histological type worldwide, while the United States (US) and other Western countries have predominantly esophageal adenocarcinoma (EAC) [2, 3]. The US distribution of esophageal cancers includes 64% adenocarcinoma, 31% squamous cell c
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