Researchers have found a malignant growth in a specific type of cancer

New research has found that esophageal cancer has almost doubled in adults between the ages of 45 and 64.

According to researchers, the data indicate the urgent need for early endoscopic screening

Esophageal cancer is a type of cancer that develops in the esophagus, a long, hollow tube that connects the throat to the stomach. Your esophagus helps your stomach digest the food you eat. Esophageal cancer usually begins with cells lining the inside of the esophagus. However, it can occur anywhere in the esophagus.

Esophageal cancer is the sixth leading cause of death from cancer worldwide. Symptoms vary depending on where you live. Smoking and alcohol use, as well as some dietary practices, and obesity may be associated with a greater risk of esophageal cancer.

A study of nearly five million patients to be screened for Digestive Disease Week 2022 found that esophageal cancer in adults aged 45 to 64 doubled between 2012 and 2019, and Barrett’s esophageal cancer increased by 50 percent.

“This strong increase in prevalence should be of concern to physicians and we should consider screening middle-aged patients if esophageal cancer is high,” said Bashar J. Kumsey, MD, MPH, FASGE, lead author. research and associate professor of medicine and head of endoscopy at the University of Florida, Gainesville. “When we see the spread of any type of cancer, we need to ask whether it is due to better screening or whether there is a real increase in the spread of this disease. In our study, the latter was the cause. ”

Researchers studied the rate of esophagogastroduodenoscopy (EGD) during this time period and found no evidence of growth to explain the prevalence data. EGD is a diagnostic procedure that examines the first part of the esophagus, stomach, and small intestine (duodenum).

Studies show that esophageal cancer and Barrett’s erythema are more common in older white men, with the most common being over 65 years of age. However, the researchers found that cancer rates doubled between the ages of 45 and 64, from 49 to 94 per 100,000 people, and that Barrett’s esophageal sphincter increased by about 50 percent to 304 to 466 per 100,000 people.

Esophageal cancer, usually diagnosed by endoscopy, is often silently deadly with minimal symptoms before it progresses. Barrett’s esophagus is the main precursor lesion of esophageal adenocarcinoma, which begins in the glandular cells of the esophageal mucosa – mostly chronic[{” attribute=””>acid reflux. Other risk factors include advanced age, male sex, obesity, smoking, and alcohol consumption.

Dr. Qumseya said that middle-aged patients with multiple risk factors would benefit from earlier and/or more frequent screening, comparing it to the benefit of earlier colorectal cancer screening. “Many patients in the U.S. now have colonoscopies starting at age 45, so conducting an endoscopy at the same time, among those with multiple risk factors, could help capture more patients with Barrett’s esophagus and esophageal cancer,” he said.

“From other analyses we have conducted with this dataset, we know that even patients with four or more risk factors for esophageal cancer are not having endoscopies,” he added. “So, from both the patient and provider perspective, we can do better.”

The study was a cross-sectional analysis of electronic health record (EHR) data from the OneFlorida Clinical Data Research Network, which covers more than 40 percent of Florida residents.

Researchers analyzed records by three age categories, 18 to 44, 45 to 64, and over 65. Further analysis of the database is ongoing, and the final results should be ready in the next six months.

Dr. Qumseya noted several limitations of the study: it covered only adults living in Florida, so is not necessarily representative of the U.S. population. It was not a randomized controlled trial that followed one group of patients over time. In addition, as with any database, there could be problems with the data itself. The EHRs analyzed were of patients who visited hospitals or doctors’ offices, so the database does not indicate whether they already had a disease at the time of that visit or whether the condition had resolved.

In the final analyses, the research team plans to revisit the database to try to differentiate between the two types of esophageal cancer – esophageal adenocarcinoma, which usually affects the lower esophagus, and squamous cell carcinoma, which affects the upper esophagus.

Reference: “Alarming increase in prevalence of esophageal cancer and Barrett’s esophagus in middle-aged patients: findings from a statewide database of over five million patients” by Bashar J. Qumseya et al., 23 May 2022. 

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