ESOCAN News

This population-based multinational case-control study across all five Nordic countries found that metformin use was associated with a substantially lower risk of esophageal squamous cell carcinoma (ESCC), with stronger protection seen at higher cumulative doses, supporting a dose-response relationship.

— 1 min read The U.S. National Cancer Institute recently released new data and analyses from the national SEER program of population-based cancer registries. They highlighted that there are now more than 18.6 million cancer survivors in the U.S. (as of 2023), and 5-year survival has reached 70%, reflecting continued progress in early diagnosis and treatment. Unfortunately, cancer incidence is continuing to increase overall, underscoring the importance of ongoing surveillance and research.

— 3 min read Courtesy of DUYTRG TRUONG While smoking and alcohol intake are the major causes of esophageal squamous cell carcinomas in most populations, exposure to environmental and occupational agents have been linked to increased risk in a number of settings (Etemadi, et al., JNCI 2024 Mar 7;116(3):379-388. doi: 10.1093/jnci/djad218. PMID: 37856326.) These include asbestos, certain solvents and adhesives, and polycyclic aromatic hydrocarbons (PAHs) generated from burning wood and coal.

— 2 min read This systematic review from investigators at the Karolinska Institute and Fujian Medical University evaluates nine risk prediction models from seven studies aimed at identifying individuals at high risk for esophageal adenocarcinoma (EAC) to improve targeted screening and early detection.

This paper describes findings from a multicenter prospective study conducted across 13 hospitals in the UK. Participants were patients (n = 910) with a known diagnosis of non-dysplastic Barrett's esophagus who underwent a capsule-sponge (Cytosponge) test followed by endoscopy. The Cytosponge test combined with biomarker analysis, including p53 staining and glandular atypia, were used to stratify patients into low, moderate, and high-risk groups for developing dysplasia or cancer.

Esophageal cancer - fast facts The Fred Hutch Cancer Center (Seattle, WA) concisely presents helpful information on causes, symptoms and treatment options for both types of esophageal cancer, as well as additional resources for patients.

This article provides a mechanistic framework relating obesity to increased risk of a number of gastrointestinal cancers, including esophageal adenocarcinoma. It also highlights the potential of weight loss interventions (e.g., lifestyle, pharmacologic, surgical) to reduce GI cancer risk. The authors describe a complex interplay of metabolic, inflammatory, microbial, and genetic factors that drive carcinogenesis in these tissues (see Figure 1).

This article addresses an interesting question: why are Barrett's esophagus patients not offered specialist counseling in much the same way as persons carrying genetic mutations (e.g., BRCA1/2) that confer increased cancer risk?

Drinking very hot beverages has long been suspected of causing esophageal squamous cell carcinoma through thermal injury; the International Agency for Research on Cancer (IARC) has classified it as "probably carcinogenic to humans." Much of the supporting evidence comes from studies in South America, particularly southern Brazil and Uruguay, where consuming very hot maté tea is an important social tradition. Similar findings have been reported from studies in the Middle East and Africa.

The journal "Best Practice & Research Clinical Gastroenterology" has dedicated an entire issue toward research on the secondary prevention of esophageal and other upper GI cancers. These review articles include such topics as artificial intelligence, risk-based screening and cost effectiveness. Rather than summarizing these 12 informative articles, I have posted the following link to the journal issue with an option to download the open source articles, which were edited by Drs. J.