Esophageal Cancer & GE Reflux: Brief Review

The United Stateshas experienced an alarming and unexplained increase in the incidence of esophageal adenocarcinoma (EAC) since the 1970s. Esophageal adenocarcinoma is the fastest growing cancer in the western world. A dramatic rise in one of the deadliest types of cancers may be linked to the increasing rates of acid reflux and gastrointestinal disorders.  Cancers of the esophagus and stomach are among the deadliest of all cancers with more than 80% of those affected dying within five years.Although cancers of the stomach (gastric cancer) have been steadily declining over the last 50 years, studies show the incidence of a cancer affecting the esophagus (esophageal adenocarcinoma) has risen by about 600% over the past few decades.

In the report, published in CA: A Cancer Journal for Clinicians, researchers reviewed studies on cancers located where the stomach ends and esophagus begins, referred to as the gastroesophageal junction (GEJ).

The major risk factors for this type of cancer are gastroesophageal reflux disease (GERD) and its associated conditions, such as Barrett’s esophagus. In Barrett’s esophagus, precancerous changes are present. Other associated risk factors include alcohol and tobacco use, obesity, and eating a diet low in fruits and vegetables.

Studies have shown that the part of the esophagus closest to the stomach is more exposed to concentrated gastric acid and a variety of agents that may contribute to the increased risk of cancer in this region.

Despite advances in screening methods for this type of cancer, researchers say more research is needed to find new ways to prevent the disease and detect it early.

Major risk factors for this cancer are Gastroesophageal Reflux Disease (GERD) and Barrett’s esophagus.

In one study frequent acid reflux (≥1 time/week) accounted for the greatest single risk factor of Esophageal Cancer  36%

1.    GE Reflux => Esophageal Cancer

2.    Sleeve => Reflux

3.    Band => Reflux

4.    Esophageal Cancer in Band and Sleeve

5.    Sleeve & Band => GE Reflux => Esophageal Cancer

Clin Gastroenterol Hepatol. 2012 May;10(5):475-80.e1. Epub 2012 Jan 13. Erosive reflux disease increases risk for esophageal adenocarcinoma, compared with nonerosive reflux. Erichsen RRobertson DFarkas DKPedersen LPohl HBaron JASørensen HT. Source Department of Clinical Epidemiology,AarhusUniversityHospital, Aarhus N,Denmark. re@dce.au.dk

In the study cohort, 26,194 of the patients over 3/4  (77%) had erosive reflux disease and
37 subsequently developed esophageal adenocarcinoma after a
mean follow-up time of ONLY 7.4 years.
Their absolute risk after 10 years was 0.24% (0.15%-0.32%).
The incidence of cancer among patients with erosive reflux disease was
significantly greater than that expected for the general population
Over Twice as high (standardized incidence ratio, 2.2; 95% CI, 1.6-3.0).

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