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Scientists Discover an Alarming Rise in a Certain Cancer Variant

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A new study found that the incidence of esophageal cancer in adults between the ages of 45 and 64 almost doubled.

According to researchers, the data indicate an urgent need for early endoscopic screening.

Esophageal cancer is a type of cancer that begins in the esophagus, a long, hollow tube that connects the throat and stomach. Your esophagus brings the food you eat to your stomach and helps it to be digested there. Esophageal cancer usually begins with the cells that line the inside of the esophagus. However, it can occur at any point in the esophagus.

Esophageal cancer is the sixth leading cause of cancer death in the world. The incidence of illness depends on where you live. Tobacco and alcohol use, and certain diets and obesity, may be associated with an increased risk of esophageal cancer.

Adults aged 45-64 years have nearly doubled the prevalence of esophageal cancer between 2012 and 2019, according to a database study of about 5 million patients published during Gastroenterology Week 2022. Barrett’s esophagus with precancerous lesions increased by 50%.

“This significant increase in prevalence is a concern for physicians, and if older patients are at higher risk, screening for esophageal cancer should be considered,” said the University of Florida. Head of Medical Research and Associate Professor and Endoscopy at Gainesville. “Whenever I see an increase in prevalence of all types of cancer, I should ask if this is simply due to improved screening or a true increase in disease prevalence. In our study, the latter was the cause. ”

Researchers examined the rate of esophagogastroduodenal endoscopy (EGD) during this period and found no evidence of an increase that could explain the prevalence data. EGD is a diagnostic procedure that examines the esophagus, stomach, and the first part of the small intestine (duodenum).

Studies show that esophageal cancer and Barrett’s esophagus are most common in older Caucasian men and are most prevalent in people over the age of 65. However, researchers have doubled the incidence of cancer in the 45-64 age group from 49 to 94 per 100,000, and Barrett’s esophagus frequency from 304 to 466 per 100,000. We found that it increased by about 50% in humans.

Esophageal cancer, which is usually detected by endoscopy, is often a silent killer with minimal symptoms until it progresses.Barrett’s esophagus-a major precursor to esophageal adenocarcinoma that begins with glandular cells in the inner layer of the esophagus-is mainly caused by chronicity[{” attribute=””>acid reflux. Other risk factors include advanced age, male sex, obesity, smoking, and alcohol consumption.

Dr. Qumseya said that middle-aged patients with multiple risk factors would benefit from earlier and/or more frequent screening, comparing it to the benefit of earlier colorectal cancer screening. “Many patients in the U.S. now have colonoscopies starting at age 45, so conducting an endoscopy at the same time, among those with multiple risk factors, could help capture more patients with Barrett’s esophagus and esophageal cancer,” he said.

“From other analyses we have conducted with this dataset, we know that even patients with four or more risk factors for esophageal cancer are not having endoscopies,” he added. “So, from both the patient and provider perspective, we can do better.”

The study was a cross-sectional analysis of electronic health record (EHR) data from the OneFlorida Clinical Data Research Network, which covers more than 40 percent of Florida residents.

Researchers analyzed records by three age categories, 18 to 44, 45 to 64, and over 65. Further analysis of the database is ongoing, and the final results should be ready in the next six months.

Dr. Qumseya noted several limitations of the study: it covered only adults living in Florida, so is not necessarily representative of the U.S. population. It was not a randomized controlled trial that followed one group of patients over time. In addition, as with any database, there could be problems with the data itself. The EHRs analyzed were of patients who visited hospitals or doctors’ offices, so the database does not indicate whether they already had a disease at the time of that visit or whether the condition had resolved.

In the final analyses, the research team plans to revisit the database to try to differentiate between the two types of esophageal cancer – esophageal adenocarcinoma, which usually affects the lower esophagus, and squamous cell carcinoma, which affects the upper esophagus.

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