Esophageal cancer has a poor prognosis, most patients do not survive 5 years after diagnosis. Two main histological subtypes are distinguished: adenocarcinoma and squamous cell carcinoma. Adenocarcinoma is usually found in the distal esophagus and associated with gastroesophageal reflux and Barrett’s is considered to be a precursor lesion. Squamous cell carcinoma is often found in the mid or proximal esophagus, risk factors are smoking, alcohol abuses and certain esophageal inflammatory conditions such as achalasia and lichen.
Morgan and colleagues have investigated esophageal cancer survival in 7 different countries (Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK) 1995 and 2014. The authors used national cancer registries to calculate 1-year and 3-year age-standardised net survival as well as incidence rates per country, subtype, sex, age group and period of diagnosis. This resulted in 185 302 cases of esophageal cancer, of which 60% was adenocarcinoma and 40% was squamous cel carcinoma. Survival improved substantially over the 20-year period in each country, particularly for adenocarcinoma and younger age groups. In the last four years of the study, survival became higher for adenocarcinoma compared with squamous cell carcinoma, with 1-year survival for adenocarcinoma of 46.9-54.4% and 39.6-53.1% for squamous cell carcinoma.
The observed improvements in survival of both esophageal cancer types suggest advances in treatment and probably earlier detection. However, the prognosis is still poor and further advances in early detection and treatment of esophageal cancer are still required. Given that several risk factors in lifestyle for both conditions are known, attention should also be focussed around prevention of esophageal cancer.
Related papers
Comment to: Boxhoorn L, van Dijk SM, van Grinsven J, Verdonk RC, Boermeester MA, Bollen TL, Bouwense SAW, Bruno MJ, Cappendijk VC, Dejong CHC, van Duijvendijk P, van Eijck CHJ, Fockens P, Francken MFG, van Goor H, Hadithi M, Hallensleben NDL, Haveman JW, Jacobs MAJM, Jansen JM, Kop MPM, van Lienden KP, Manusama ER, Mieog [more info]
Gyawali CP, Tutuian R, Zerbib F, Rogers BD, Frazzoni M, Roman S, Savarino E, de Bortoli N, Vela MF, Sifrim D. Gastroenterology. 2021 Nov;161(5):1412-1422. doi: 10.1053/j.gastro.2021.07.004. When patients have persistent reflux symptoms while being treated with proton pump inhibitors (PPI), the key question is whether they have indeed PPI refractory reflux disease or another disorder [more info]
Comment to: Selvaraj EA, Mózes FE, Ajmer Jayaswal AN, Zafarmand MH, Vali Y, Lee JA, Levick CK, Joseph Young LA, Palaniyappan N, Liu CH, Aithal GP, Romero-Gómez M, Brosnan MJ, Tuthill TA, Anstee QM, Neubauer S, Harrison SA, Bossuyt PM, Pavlides M; LITMUS Investigators. Diagnostic accuracy of elastography and magnetic resonance imaging in patients with [more info]