58 - Risk factors for Oesophageal Carcinoma

Factors Associated with Pathogenesis of Esophageal Cancer

Factor Squamous Cell Cancer Adenocarcinoma Smoking +++ + Alcohol consumption +++ – Hot beverages + – N-nitroso compounds (e.g., pickled vegetables) + – Betel nut chewing + – Maté drinking + – Deficiencies of green vegetables and vitamins + – Low socioeconomic class + – Fungal toxin or virus + – History of radiation to the mediastinum + + Lye corrosive stricture + – History of aerodigestive malignancy +++ – Plummer-Vinson syndrome + – Obesity – ++ Achalasia + – Gastroesophageal reflux – +++ Barrett's esophagus – ++++

*Observe that Adenocarcinoma is associated with only 5 of all the factors listed above. They are Barrett's esophagus, GERD, Obesity, Smoking and radiation to the mediastinum. *Squamous cell cancer of esophagus is not associated with Obesity, GERD and Barrett's esophagus. *The most common location of squamous cell carcinoma of esophagus is the middle and lower third of esophagus. *The most common location of adenocarcinoma of esophagus is the lower third of the esophagus. *The most common type of esophageal carcinoma in WEST is adenocarcinoma, which is on the rise recently. *The most common type of esophageal carcinoma in INDIA and ASIA is squamous cell carcinoma. (reasons being less incidence of GERD, obesity and barrett's esophagus in asian population when compared to the west and high incidence of H.PYLORI, which is thought to be protective against adenocarcinoma; in asian population. )