Epidemiology of esophageal adenocarcinoma.
The incidence of esophageal adenocarcinoma has risen rapidly over the past 25 years in the United States as well as in several Western European countries. This increase had been most dramatic among white males. The majority of these cancers arise from a background of premalignant Barrett esophagus. However, less than 10% of the patients with esophageal adenocarcinoma were known to have Barrett esophagus previously. It is uncertain which risk factors contribute to the increasing incidence of esophageal adenocarcinoma, although gastroesophageal reflux disease, cigarette smoking, and obesity have been implicated. Whereas infection with Helicobacter pylori and use of non-steroidal anti-inflammatory drugs are associated with reduced risk, low intakes of fruit, vegetables, and cereal fibers seem to increase the risk of esophageal adenocarcinoma. Presently there is no evidence that strongly supports any specific strategy to screen a subgroup of the population at risk for Barrett esophagus and adenocarcinoma of the esophagus.
Pera
Manuel
M
Section of Gastrointestinal Surgery, Hospital Universitari del Mar, Universitat Autónoma de Barcelona, Passeig Maritim 25-29, 08003 Barcelona, Spain. pera@imas.imim.es
Manterola
Carlos
C
Vidal
Oscar
O
Grande
Luis
L
D000230:Adenocarcinoma / Q000453:epidemiology* / Q000209:etiology; D000428:Alcohol Drinking / Q000009:adverse effects; D001471:Barrett Esophagus / Q000150:complications; D002299:Cardia; D004032:Diet; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D004943:Esophagogastric Junction; D005060:Europe / Q000453:epidemiology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D008297:Male; D009765:Obesity / Q000150:complications; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D015996:Survival Rate; D014481:United States / Q000453:epidemiology