Secondary prevention of esophageal squamous cell carcinoma in areas where smoking, alcohol, and betel quid chewing are prevalent.
Esophageal cancer is ranked as the sixth most common cause of cancer death worldwide and has a substantial effect on public health. In contrast to adenocarcinoma arising from Barrett's esophagus in Western countries, the major disease phenotype in the Asia-Pacific region is esophageal squamous cell carcinoma which is attributed to the prevalence of smoking, alcohol, and betel quid chewing. Despite a multidisciplinary approach to treating esophageal cancer, the outcome remains poor. Moreover, field cancerization reveals that esophageal squamous cell carcinoma is closely linked with the development of head and neck cancers that further sub-optimize the treatment of patients. Therefore, preventive strategies are of paramount importance to improve the prognosis of this dismal disease. Since obstacles exist for primary prevention via risk factor elimination, the current rationale for esophageal cancer prevention is to identify high-risk groups at earlier stages of the disease, and encourage them to get a confirmatory diagnosis, prompt treatment, and intensive surveillance for secondary prevention. Novel biomarkers for identifying specific at-risk populations are under extensive investigation. Advances in image-enhanced endoscopy do not just substantially improve our ability to identify small precancerous or cancerous foci, but can also accurately predict their invasiveness. Research input from the basic sciences should be translated into preventive measures in order to decrease the disease burden of esophageal cancer.
Chung
Chen-Shuan
CS
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Lee
Yi-Chia
YC
Wang
Cheng-Ping
CP
Ko
Jenq-Yuh
JY
Wang
Wen-Lun
WL
Wu
Ming-Shiang
MS
Wang
Hsiu-Po
HP
D000230:Adenocarcinoma / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D000428:Alcohol Drinking / Q000009:adverse effects*; D001114:Areca; D001208:Asia; D001471:Barrett Esophagus / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008409:Mastication; D010139:Pacific Islands; D015995:Prevalence; D012307:Risk Factors; D055502:Secondary Prevention; D012907:Smoking / Q000009:adverse effects*