Esophageal cancer affects the oesophagus, and 16,000 new cases are identified with 14,000 deaths annually. Esophageal cancer forms silently, becoming symptomatic only in later stages, which is the primary reason for its low survival rate. Patients with GERD or Barrett's oesophagus are at higher risk of esophageal cancer and may benefit from regular screening for precancerous changes.
The type of esophageal cancer is determined by the cells affected. Squamous cell carcinoma (SCC) affects squamous cells, and adenocarcinoma is cancer that starts in mucus-producing cells. SCC affects primarily African Americans, while adenocarcinoma affects primarily Caucasians.
Symptoms of esophageal cancer include food getting stuck in the throat or coming back up, painful swallowing, chest or back pain, weight loss, indigestion and chronic hoarseness.
Risk factors for SCC are a history of gastro-oseophageal reflux disease (GERD), smoking and alcohol use. For adenocarcinoma esophageal cancer, the risk factors are GERD and obesity.
Current survival rates are 18 per cent for Caucasians and 11 per cent for African Americans. The low survival rate is due to the lack of early symptoms of esophageal cancer.
In the 1960s, five-year survival rates were 4 per cent for Caucasians and 1 per cent for African Americans.
Esophageal cancer is more common in Asia and Africa than in the United States, with SCC being most prevalent. In the US, adenocarcinoma has risen 2 per cent a year for Caucasian men, while the rate for Caucasian women has not changed. SCC in African Americans is declining.
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