Esophageal Cancer on the Rise
Obesity, alcohol consumption, and diet may all be behind the increase in esophageal cancer cases in recent decades. Esophageal adenocarcinoma is the type of esophageal cancer that is increasing the fastest in the United States.
The increase in the number of people with esophageal cancer has been one of the fastest compared with other cancer types, says gastroenterologist Leon J. Yoder, DO, who practices at the Cancer Treatment Centers of America at Southwestern Regional Medical Center in Tulsa, Okla.
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“It seems like esophageal cancer is an epidemic worldwide,” Dr. Yoder says, adding that in the United States, esophageal cancer incidence is 5 or 6 cases in 100,000 — but in China, for example, the incidence is 10 times that. Worldwide, the esophageal cancer type called squamous cell esophageal carcinoma is of greater concern, but in the United States, esophageal adenocarcinoma is the most common esophageal cancer type.
The exception to the observed increase may be African-American men, a group which has seen a dramatic decrease in the number of esophageal cancer cases and deaths in the past decades.
Reasons for the Rise in Esophageal Cancer
Most experts agree that lifestyle factors are contributing to the growing number of esophageal cancer cases. These include:
Obesity. The rise in obesity in the United States seems to parallel the rise in esophageal cancer. And indeed, according to a recent study, abdominal obesity may be related to esophageal cancer risk: The greater your abdominal girth, the greater your chances of developing esophageal cancer. This could explain why men are three times more likely than women to have esophageal cancer, as abdominal obesity is more common in men.
Alcohol. People who drink a lot of alcohol, especially hard liquor, are at increased risk for esophageal cancer.
Smoking. Although smoking rates have declined somewhat nationally, the link between smoking cigarettes and esophageal cancer is a strong one.
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Diet. Yoder points to a modern diet high in fat and red meat but low in fruits and vegetables as a significant contributor to increasing esophageal cancer rates.
GERD. Chronic acid reflux, which may be diagnosed as gastro-esophageal reflux disease (GERD) appears to be on the rise, contributing to higher numbers of people diagnosed with Barrett’s esophagus, an inflammation of the tissues that increases the risk of developing esophageal cancer. Yoder advises that people who are treated for GERD for five years should seek screening to find out whether they have Barrett’s esophagus.
Hot liquids. Yoder attributes part of the significant incidence of esophageal cancer in China to drinking very hot tea from a young age.
“If we take all of these things in account, it’s probably a combination of several of these that contributes to our risk,” Yoder says. “Our lifestyle in this country is not the best. We are overweight, eat the wrong type of foods, [and] eliminate a lot of the good foods we need to keep ourselves healthy.” He adds that family history also plays a role for some people.
Don’t Join the Esophageal Cancer Crowd
Yoder advises that people who are worried about their risk of esophageal adenocarcinoma or other forms of esophageal cancer do the following:
Lose weight. Check with your doctor to find out what a healthy weight goal is for you — and whether you should be concerned about your waistline.
Eat healthfully. A diet that emphasizes fruits and vegetables, at least five servings a day, could be protective against esophageal cancer — and can even speed healing during treatment, Yoder says.
Get screened. Screening for esophageal cancer — or specific tests utilized to detect a pre-cancerous or early cancer stage — is not recommended for everyone. Screening has been shown to be beneficial for those at high risk. Yoder recommends screening around age 50, particularly for people who are obese, consume a lot of alcohol, smoke, or have a history of GERD. Screening can find cancer before esophageal cancer symptoms are present — and the earlier cancer is identified, the easier it is to treat.
Esophageal cancer may be on the rise, but you do not have to be part of that trend. Learning about the causes of the increasing number of cases can help you make good decisions about your own health.