Other risk factors for esophageal cancer - What is cancer of the esophagus

 Other risk factors for esophageal cancer - What is cancer of the esophagus

Esophageal cancer
Esophageal cancer is the 8th in tumor frequency and 6 in mortality. This is a public health problem, such as that in spite of their low incidence has a high mortality (around 90% of all patients). This is because more than half of the patients are diagnosed in locally advanced or metastatic phase (ie unresectable).

How is the esophagus

The esophagus is a relatively straight tube that connects the pharynx to the stomach. In humans is about 25 cm and the layered structure shows typical digestive tract, which are (from the inside out) mucosa, submucosa, muscularis and serosa (or adventitia).

The lining is formed by a stratified squamous epithelium normally nonkeratinized (without keratin, as the epidermis), while the submucosa is dense connective tissue with a large amount of elastic fibers that allow for expansion when the bolus passes. The light (the inside) of the esophagus is formed by several longitudinal folds of the mucosa and submucosa. Externally have the adventitia , which consists of loose connective tissue and is responsible for fixing the esophagus to the body.

Types and incidence of esophageal cancer

90% of esophageal cancer are squamous histology (usually located in the upper and middle) or adenocarcinomas (lower third), the remaining 10% are other types as mixed (adenosquamous), sarcomas, small cell, etc. .

Its incidence makeup and countries is very variable. Until the 60s of last century, 90% of esophageal tumors were squamous and adenocarcinomas were so rare that even doubted his existence. Since then the incidence of adenocarcinoma of the esophagus (cardia and gastroesophageal junction) has been increasing in Western countries. While the incidence of squamous remains unchanged or is reduced by decreasing the causes which produce it ( Alcohol and snuff), adenocarcinomas have increased in the Western world probably in proportion to the increase of gastroesophageal reflux (associated with obesity ) and further development of Barrett's esophagus (exchange or replacement-mataplasia-cells that normally line the esophagus end with more resistant to stomach acid). Patients with recurrent symptoms of reflux have a risk of developing esophageal adenocarcinoma seven times and up to 40 times if the symptoms are severe prolonged further. Unlike squamous, adenocarcinoma is not related to alcohol consumption (even if the smoking habit ).

Other risk factors for esophageal cancer

Certain socioeconomic factors may also influence the development of cancer of the esophagus, as it has seen an increase in incidence in diets low in fruits and vegetables in economically depressed regions. The habit of drinking very hot drinks ( tea or coffee ) in regions like the Middle East and China has also been associated with an increased incidence of esophageal cancer and eating foods rich in nitrous (some pickled vegetables) and other foods ( mushroom growers), or some nuts prepared in these endemic areas.

The excessive intake of red meat, low levels of selenium, zinc and folic acid in the diet, history of esophageal achalasia (esophageal motility disorder resulting in dilation of the same or megaesophagus), caustic scars (by ingestion of bleach , acids, etc.), history of gastrectomy, atrophic gastritis ... are other risk factors for the occurrence of esophageal cancer.