Prevalence Of Esophageal Cancer Research Articles

Endoscopic detection of early esophageal cancer in a high-risk population: does Lugol staining improve videoendoscopy?

Background: The aim of this study was to prospectively compare the diagnostic accuracy of videoendoscopy, with and without Lugol staining, for the detection of esophageal cancer in alcoholic or smoking patients older than 40 years. Methods: Daily alcohol and tobacco consumption and overt and latent symptoms were noted. The 158 patients included were examined by videoendoscopy and with Lugol dye. Results: The mean consumption of alcohol and tobacco was 86 ± 49 gm/day for 26 ± 11 years, and 30 ± 18 pack-years, respectively. Twenty-five patients had no symptoms. Before Lugol staining, 12 patients had endoscopically identified cancerous lesions. After Lugol staining, 13 patients had 17 esophageal cancers, 3 of which were high-grade dysplasia. The prevalence of esophageal cancer was 8.2%: 95% CI [4,14]. Dye-free surfaces were significantly larger than the endoscopic patterns observed before Lugol staining (11.6 ± 9.2 cm 2 vs 1.4 ± 1.7 cm 2; p < 0.02). Conclusions: In an alcoholic smoking population, the prevalence of esophageal cancer detected by endoscopy is high and not related to symptoms described by patients. Lugol staining only moderately improves the diagnostic accuracy of videoendoscopy; its main advantage is the assessment of the mucosal extension of esophageal cancer. (Gastrointest Endosc 1997;45:480-4.)

Serologic association between human papillomavirus type 16 infection and esophageal cancer in Shaanxi Province, China.

The existence of large geographic variations in the prevalence of esophageal cancer in some countries, such as China, indicates that environmental risk factors may be important in the development of this disease. Some studies have implicated genital-mucosal strains of human papillomaviruses (HPVs) in the etiology of this cancer. We conducted a case-control study in Shaanxi Province, China, an area with a population at high risk for esophageal cancer, to assess the association of this disease with infection by HPV type 16 (HPV16), the most common cancer-associated genital-mucosal HPV type. Ninety individuals with esophageal cancer and 121 cancer-free control subjects were identified among the patients in two hospitals in Xi'an, Shaanxi Province. The control subjects were matched to the case patients on the basis of age and sex. Blood specimens were drawn from all study subjects, and serum was isolated by routine methods. The presence of HPV16 antibodies in serum samples was determined by use of an enzyme-linked immunosorbent assay (ELISA) that used baculovirus-derived HPV16 virus-like particles as the antigen. A similar ELISA that used bovine papillomavirus type 1 (BPV1) virus-like particles as the antigen controlled for the specificity of HPV16 seroreactivity. Data from the HPV16 and the BPV1 assays were normalized with respect to results obtained in each assay with a control serum of known HPV16 seroreactivity. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine the association between HPV16 seroreactivity and esophageal cancer. Reported P values are two-sided. The mean seroreactivity to HPV16 virus-like particles was significantly higher for the cancer patients than for the control subjects (mean value +/- standard deviation = 0.85 +/- 0.22 versus 0.74 +/- 0.18; P<.0001). When the cancer patients and control subjects were compared by sex and age groups, the differences in mean seroreactivity remained statistically significant. The difference in mean seroreactivity to BPV1 virus-like particles between cancer patients and control subjects was not statistically significant (0.81 +/- 0.28 versus 0.88 +/- 0.32; P = .12); this result was not altered when sex and age groups were compared. By use of a cutoff point for HPV16 seropositivity that was established in studies of cervical neoplasia, 24% of the cancer patients were seropositive compared with 7% of the control subjects, yielding a sex- and age-adjusted OR of 4.5 (95% CI = 1.8-11.9). In general, the OR for esophageal cancer increased with increasing HPV16 seroreactivity. HPV16 infection may be a risk factor for esophageal cancer. Further studies of the association between HPV16 infection and the incidence of esophageal cancer are needed.

Natural occurrence of some Fusarium mycotoxins in corn from low and high esophageal cancer prevalence areas of the Transkei, Southern Africa

ADVERTISEMENT RETURN TO ISSUEPREVArticleNEXTNatural occurrence of some Fusarium mycotoxins in corn from low and high esophageal cancer prevalence areas of the Transkei, Southern AfricaEric W. Sydenham, Pieter G. Thiel, Walter F. O. Marasas, Gordon S. Shephard, Dirk J. Van Schalkwyk, and Klaus R. KochCite this: J. Agric. Food Chem. 1990, 38, 10, 1900–1903Publication Date (Print):October 1, 1990Publication History Published online1 May 2002Published inissue 1 October 1990https://doi.org/10.1021/jf00100a004RIGHTS & PERMISSIONSArticle Views583Altmetric-Citations329LEARN ABOUT THESE METRICSArticle Views are the COUNTER-compliant sum of full text article downloads since November 2008 (both PDF and HTML) across all institutions and individuals. These metrics are regularly updated to reflect usage leading up to the last few days.Citations are the number of other articles citing this article, calculated by Crossref and updated daily. Find more information about Crossref citation counts.The Altmetric Attention Score is a quantitative measure of the attention that a research article has received online. Clicking on the donut icon will load a page at altmetric.com with additional details about the score and the social media presence for the given article. Find more information on the Altmetric Attention Score and how the score is calculated. Share Add toView InAdd Full Text with ReferenceAdd Description ExportRISCitationCitation and abstractCitation and referencesMore Options Share onFacebookTwitterWechatLinked InReddit PDF (591 KB) Get e-Alerts Get e-Alerts

Water Contamination and Esophageal Cancer at Gassim Region, Saudi Arabia

Between January 1980 and December 1982, 183 patients with histologically confirmed carcinoma of the esophagus who were referred to a tertiary referral hospital were studied. Thirty-two (17%) patients were referred from Gassim Region at the north central part of Saudi Arabia. In contrast, only 5% of total cancer patient referrals were from this area. A case-control study showed a significant regional difference within Saudi Arabia and the most referrals from Gassim area. A prospective case-control study showed persistently high numbers of referrals from that region during 1983-1987. When patients from Gassim Region were compared with those referred from other locations, no statistical differences were noted between the two groups except for the source of drinking water. Water analysis from Gassim area showed a high solid content with elevated levels of calcium, magnesium, and to a lesser extent, chromium iron, cadmium, and cobalt. Traces of petroleum oil were found in five of six water samples from Gassim during 1983, compared with 3 of 49 samples from other areas. Mutagenicity tests on water specimens form Gassim Region indicated the presence of possible carcinogens. It is being suggested that the high prevalence of esophageal cancer in this region may be related to contamination of water by impurities such as petroleum oils. Malnutrition, particularly vitamin A deficiency, as well as other factors may have promoted such malignancies.

Adenocarcinoma and Barrett's esophagus: An overrated risk?

The risk of developing esophageal cancer in Barrett's esophagus has been estimated at about 10%. This estimate is based primarily on data concerning the prevalence of that association in series of hospitalized patients and autopsies—a practice that tends to exaggerate the risk. We have reviewed retrospectively our experience with 115 patients whom we treated for Barrett's esophagus between September 1962 and March 1983, and have distinguished our data on the prevalence of esophageal cancer from that on incidence. For 8 patients, we found both Barrett's esophagus and esophageal adenocarcinoma during the initial evaluations for a prevalence ratio of 7%. We followed 105 patients not found to have esophageal cancer initially for a total of 350 person-years. Only 2 patients developed adenocarcinoma during that follow-up period for an incidence of 1 case per 175 person-years. This incidence, although some 40-fold greater than that of the general population, is substantially lower than previously estimated. Routine endoscopic and histologic surveillance has been recommended for patients with Barrett's esophagus because of the alleged high incidence of esophageal cancer. Inasmuch as that incidence now appears to be low, we question the value of such surveillance for these patients.

Tentative correlations of plant usage and esophageal cancer zones

Reports on the geographical distribution of cancer show an abnormally high incidence of cancer of the esophagus in zones or strips widely scattered across the world (19, 20, 39, 47). Analyses of epidemiological studies in the high-risk areas show no convincing correlation between the disease and consumption of alcohol and tobacco, or the intake of food or beverages at high temperatures. Though these have been repeatedly put forward as causative factors (7, 10, 13, 22, 38, 71), there is good evidence to the contrary. For instance, in the Province of Honan, in northern China, where the prevalence of esophageal cancer is highest of all, there is hardly any imbibing of alcohol (37). In a survey of 11 Latin American cities and San Francisco, there was found no correlation between "mortality from this cancer and from all forms of alcoholism" (51). In Bombay (16) and elsewhere, there are numerous victims who have never smoked. In Central Asia, the area ranking second in esophageal cancer incidence, scalding-tea drinking by the Kazaks has proved to be almost equal among victims and controls. Alcohol, not consumed by females, was found to play no essential role (6). Further, the high rate of esophageal cancer among sheep in the Cape Province, drenched and grazed on grassland, as against those similarly drenched and grazed in scrub (57); and the common occurrence of neoplasia of the esophagus and rumen in Zebu cattle grazed in a remote valley of the Masai reserve in Kenya (49), indicate that plants, intrinsically carcinogenic or rendered so by soil and water conditions, offer better suspects than smoking, alcohol and hot beverages. It is inconceivable that carcinogens specific to the esophagus should be largely limited to the high-risk zones of the world.