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Rising Rate of Esophageal Cancer in the U.K.; Relationship to Obesity

Posted Sep 02 2010 12:00am

I came across an interesting news items about the rising rate of esophageal cancer in the U.K. This initially surprised me because I assumed that smoking/drinking were declining in the U.K. These behaviors have a causal relationship to squamous cell carcinoma of the esophagus, but read on (see: Oesophageal Cancer Rates In Men Up 50 Per Cent In A Generation, UK ), Below is an excerpt from the article:

Oesophageal cancer rates in men [in the U.K.] have risen by 50 per cent over the last 25 years, according to new figures....In 1983 around 2,600 men were diagnosed with oesophageal cancer ...and according to the latest figures around 5,100 men were diagnosed with the disease. The most dramatic rise was among men in their 50s, as rates increased by 67 per cent over the same period. Rates in women also rose, but only by eight per cent, from 5.1 to 5.5 per 100,000 people...."[W]e think the obesity epidemic may be a big reason behind the increase [said an author of the study]. We know that being overweight significantly increases the risk of adenocarcinoma - the main type of oesophageal cancer that's on the up. Our changing diets are also likely to be influencing the rise with people eating less fruit and vegetables....In 1983, 9.6 in every 100,000 men were diagnosed with oesophageal cancer but now 14.4 in every 100,000 men are diagnosed with the disease - an increase of 50 per cent.

On a hunch and to pursue this topic further, I googled the key words esophageal cancer and obesity. Here's an article on the topic with an excerpt below (see: Esophageal Cancer and the Effects of Obesity ):

GERD, or gastroesophageal reflux disease, is one of the more common effects of obesity. GERD causes stomach fluid to leak into the esophagus, damaging the delicate inner lining of the esophagus. GERD can cause a condition known as Barrett's esophagus, which increases the incidence of esophageal cancer. For unknown reasons, the incidence of esophagus cancer has risen dramatically over recent years in the United States and Europe. Researchers at the University of Michigan (2007) documented a 350 percent increase in esophageal adenocarcinoma, a type of esophagus cancer, since the 1990s. Researchers are trying to determine why this increase has occurred at a time when stomach cancers have decreased....[The answer to this question of the rising rate may lie with the relationship between Barrett's Esophagus and cancer of the esophagus]. Barrett's esophagus is a condition in which the inner lining of the esophagus is replaced with tissue resembling the intestinal lining....[P]eople with GERD are up to five times more likely to develop Barrett's esophagus....According to one theory, excess abdominal fat pushes stomach acids back up into the esophagus, starting the cycle of inflammation that can lead to Barrett's esophagus.

So piecing all of this together: obesity > GERD > Barrett's esophagus > adenocarcinoma of the esophagus. However, there is still the need to explain why the incidence of adenocarcinoma of the esophagus is not rapidly rising in the U,K. among women. It's possible that, overall, they do not suffer from the same rate of obesity as men or that, for some reason, they do not have the same incidence of GERD in the face of their obesity. I have blogged before about how various diseases as linked to "lifestyle" issues (see: Seeking the Correct Definition for a "Lifestyle Disease" ; Can We Reduce the Number of Preventable Deaths Occurring Yearly in the U.S.? ). It looks like we can place adenocarcinoma of the esophagus in this same column.

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