See chapter 7.3 page 253 in the WCRF/AICR Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective.
462,000 new cases in 2002
Marked geographical differences (Oesophageal cancer belt).
Occurs around four times more commonly in low- to middle- than in high-income countries. (In rural Linxian in China, it is the leading cause of death.)
Higher incidence in males (2/3 of cancer occurs in males).
Great majority = squamous cell carcinoma.
Survival = poor (75% die within a year)
Non-dietary risk factors:
- Smoking tobacco
- Barrett’s oesophagus
- Direct DNA damage, or cell damage, death and hyperproliferation
- Role of mutated oncogenes/ tumour suppressor genes
- Natural history of the disease: Normal oesophagus → Chronic oesophagitis → Atrophy → Dysplasia → Cancer
- Alcohol (acetaldehyde)
- Thermal damage
- Various chronic proliferative lesions (Barrett’s oesophagus)
- Body fatness
CONVINCING EVIDENCE - decreases risk:
CONVINCING EVIDENCE - increases risk:
- Body fatness
PROBABLE EVIDENCE - decreases risk:
- Vegetables, fruits
- Foods containing beta-carotene and vitamin C
PROBABLE EVIDENCE - increases risk:
- Maté - herbal infusion drink (as drunk in parts of South America - scalding hot through metal straw)
LIMITED/SUGGESTIVE EVIDENCE - decreases risk:
Foods containing dietary fibre, folate, pyridoxine and vitamin E
LIMITED/SUGGESTIVE EVIDENCE - increases risk:
Red meat and processed meat
Most effective means of preventing:
- NOT to use tobacco
Most effective dietary means of preventing:
- Consumption of varied diets high in fruits and vegetables
- Avoiding alcohol
Oesophagus cancer incidence is twice as high in men as in women.
What could be the reason(s) for that?