Incidence, Survival and Prevalence of Esophageal and Gastric Cancer in Linzhou City from 2003 to 2009

Liu, Shu-Zheng,Wang, Bing,Zhang, Fang,Chen, Qiong,Yu, Liang,Cheng, Lan-Ping,Sun, Xi-Bin,Duan, Guang-Cai Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.10

This study describes recent trends in incidence, survival and prevalence of subgroups of esophageal and gastric cancer in Linzhou city between 2003 and 2009. Data of esophageal and gastric cancer for the period of interest were extracted from the Linzhou Cancer Registry. Using information on tumor morphology or anatomical site, data were divided into six groups; esophageal squamous cell carcinoma, esophageal adenocarcinoma, other and unspecified types of esophageal cancer, and cardia, non-cardia, and unspecified anatomical site of stomach cancer. Incidence, survival and prevalence rates for each of the six cancer groups were calculated. The majority of esophageal cancers were squamous cell carcinomas (82%). Cardiac cancer was the major gastric cancer group (64%). The incidence of esophageal squamous cell carcinoma and gastric cardiac cancer increased between 2003 and 2009. Both esophageal and gastric cancer had a higher incidence in males compared with females. Overall survival was poor in all sub-groups with 1 year survival ranging from 45.9 to 65.6% and 5 year survival ranging from 14.7 to 30.5%. Prevalence of esophageal squamous cell carcinoma and gastric cardiac cancer was high (accounting for 80% overall). An increased focus on prevention and early diagnosis, especially in esophageal squamous cell carcinoma and gastric cardiac cancer, is required.

Esophageal Cancer in Brunei Darussalam over a three Decade Period: an Epidemiologic Study of Trends and Differences between Genders and Racial Groups

Chong, Vui Heng,Telisinghe, Pemasari Upali,Chong, Chee Fui Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.9

Background: Carcinoma of the esophagus is associated with significant morbidity and mortality. The most common subtype is squamous cell carcinoma (SCC). In the past three decades, the incidence of SCC has been reported to be decreasing whereas esophageal adenocarcinoma (AC) is increasing. This study assessed the trend of esophageal cancer in Brunei Darussalam over a three decades period. Materials and Methods: The National Cancer registry was searched for esophageal cancers from 1986 to 2012. Data on age, gender, racial groups (Malays, Chinese, Indigenous and foreign nationals) and histology type were collected. The rate (ASR) and Age Specific Incidence rate (ASIR) were calculated. Results: The predominant tumor type was SCC which accounted for 89% of all esophageal cancer. The gender ratio was 2.25: 1 (male: female) and the mean age at diagnosis was $66.9{\pm}12.9$ years, significantly younger for esophageal AC ($57.2{\pm}16.0$) compared to SCC ($68.1{\pm}12.0$, p<0.05), and among the foreign nationals (p<0.05 for trend). The proportions of SCC among all esophageal cancers in the various racial groups were: Malays (87.8%), Chinese (100%), Indigenous (100%) and foreign nationals (20%). None of the Chinese and Indigenous groups were diagnosed with esophageal AC. The overall ASR for esophageal cancer was 2.1/100,000; 2.0/100,000 for SCC with a declining trend and 0.17/100,000 for esophageal AC, without any trend observed. Among the two major racial groups; the Chinese has higher ASR (3.42/100,000) compared to the Malays (ASR 0.95/100,000). Conclusions: SCC is the predominant tumor type of esophageal cancer in Brunei Darussalam and more common among the Chinese. There was a declining trend in the incidence of SCC but not for esophageal AC.

Epidemiological Characteristics and Prediction of Esophageal Cancer Mortality in China from 1991 to 2012

Tang, Wen-Rui,Fang, Jia-Ying,Wu, Ku-Sheng,Shi, Xiao-Jun,Luo, Jia-Yi,Lin, Kun Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.16

Background: To analyze the mortality distribution of esophageal cancer in China from 1991 to 2012, to forecast the mortality in the future five years, and to provide evidence for prevention and treatment of esophageal cancer. Materials and Methods: Mortality data for esophageal cancer in China from 1991 to 2012 were used to describe its epidemiological characteristics, such as the change of the standardized mortality rate, urban-rural differences, sex and age differences. Trend-surface analysis was used to study the geographical distribution of the mortality. Curve estimation, time series, gray modeling, and joinpoint regression were used to predict the mortality for the next five years in the future. Results: In China, the incidence rate of esophageal cancer from 2007 and the mortality rate of esophageal cancer from 2008 increased yearly, with males at $8.72/10^5$ being higher than females, and the countryside at $15.5/10^5$ being higher than in the city. The mortality rate increased from age 45. Geographical analysis showed the mortality rate increased from southern to eastern China, and from northeast to central China. Conclusions: The incidence rate and the standardized mortality rate of esophageal cancer are rising. The regional disease control for esophageal cancer should be focused on eastern, central and northern regions China, and the key targets for prevention and treatment are rural men more than 45 years old. The mortality of esophageal cancer will rise in the next five years.

Esophageal Cancer, Gastric Cancer and the use of Pesticides in the Southwestern of Turkey

Yildirim, Mustafa,Kaya, Vildan,Yildiz, Mustafa,Demirpence, Ozlem,Gunduz, Seyda,Dilli, Utku Donem Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.6

Background: Esophageal and gastric cancer generally have a poor prognosis and may share common risk factors. It has been demonstrated that the pesticide usage may contribute to development of many cancer types. In this study, the relation between amount of pesticides used in agriculture and esophageal and gastric cancer incidence was researched. Materials and Methods: Findings from the data bank of the Ministry of Health Provincial Health Directorate Cancer Records Center between the years of 1998-2010 were used. All patients who were diagnosed with gastric and esophageal cancer histopathologically were included. Data for annual pesticide usage were obtained from Provincial Agriculture Directorate for the same time period. Statistical analysis was performed using the Spearman test. Results: One thousand eight hundred and ninety-six patients were involved in the study, 1,233 males (65%) and 663 females (35%), 230 with esophageal cancer (12.1%) and 1,666 with gastric cancer (87.9%). No statistically significant relation was apparent between pesticide amount used and esophageal cancer (p: 0.87). Conclusions: In our study, there was no relationship between pesticide usage and esophageal or gastric cancer. However, the time between pesticide usage and cancer development was not known, qualifying the comparison.

Quality of Life for Patients with Esophageal/Gastric Cardia Precursor Lesions or Cancer: A One-year Prospective Study

Wen, Ying,Pan, Xiong-Fei,Huang, Wen-Zhi,Zhao, Zhi-Mei,Wei, Wen-Qiang,Chen, Feng,Lan, Hui,Huang, He,Yang, Chun-Xia,Qiao, You-Lin Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.1

Background: The current study examined health-related quality of life (QoL) for patients with esophageal/gastric cardia precursor lesions or cancer before and after treatment to facilitate improved prevention and treatment. Materials and Methods: Patients with different stages of esophageal/gastric cardia lesions completed two QoL questionnaires, EORTC QLQ-C30 and supplemental QLQ-OES 18, before primary treatment, and at 1, 6 and 12 months after treatment. Results: Fifty-nine patients with precursor lesions, 57 with early stage cancer, and 43 with advanced cancer responded to our survey. Patients with precursor lesions or early stage cancer reported better QoL overall than those with advanced cancer before treatment (p<0.01). Global QoL scores before treatment and at 1 month after treatment were $71{\pm}9$ versus $69{\pm}9$ (p>0.01), $71{\pm}8$ versus $61{\pm}11$ (p<0.01), $67{\pm}11$ versus $62{\pm}9$ (p<0.01) for three stages of lesions. At 6 months after treatment, some QoL measures recovered gradually in precursor lesion and early cancer patients, while some continuously deteriorated in advanced cancer patients. At 12 months, all QoL scores were comparable to baseline for patients with precursor lesions (p>0.01), while global QoL, social, pain, and insomnia scores for early stage and advanced cancer were inferior to corresponding baseline levels (difference between means>5, p<0.01). At this time point, compared with patients with early stage cancer, those with advanced cancer showed worse QoL with all function and most symptom measures (p<0.01). Conclusions: Patients with precursor lesions or early stage esophageal/gastric cardia cancer show better QoL than those with advanced cancer. This indicates that screening, early diagnosis and treatment may improve the QoL for esophageal/gastric cardia cancer patients. Target intervention and counseling should be given by health care providers during treatment and follow-up to facilitate QoL improvement.

식도와 위에 발생한 원발성 중복암 3예

손혜숙,김진수,조영석,김형근,민정요,김윤지,채현석,백명기 대한소화기내시경학회 2009 Clinical Endoscopy Vol.38 No.1

Double primary cancer means that more than 2 cancers occur independently in an individual. There have been many reports on double primary cancer since Billroth reported it for the first time in 1889 and Warren and Gates established it. The incidence of esophageal cancer is low, about 1~2% of all cancer and, 7% of all gastrointestinal cancer, but double cancer with including esophageal cancer is 9.5~27% of all double primary cancer. Double primary cancer of the esophagus and stomach has occasionally been reported. We have experienced three cases of double primary cancer of squamous carcinoma in the esophagus and adenocarcinoma in the stomach. In this study we reviewed the clinical characteristics of the reported cases of double primary esophageal and gastric cancer that have been reported in Korea and these three cases we experienced at our hospital. 두 개 이상의 암이 각각 독립해서 발생하고 서로 종속 관계가 없으면 이를 원발성 중복암이라고 한다. 이는 1879년 Billroth가 처음 보고하고 1932년 Warren과 Gates에 의해 정립된 이래 문헌상 보고되는 중복암의 빈도는 점점 증가하고 있다. 중복암의 대부분은 두경부암이 차지하고 다음이 피부암, 유방암, 전립선암, 폐암의 순서로 나타난다. 식도암은 악성종양의 1~2%, 소화기계 악성종양의 7%로 빈도는 높지 않으나 식도암을 포함한 중복암은 9.5~27%로 다양하게 보고되고 있다. 식도와 위에 발생한 원발성 중복암은 국내 보고가 산발적으로 있었다. 저자들은 식도의 편평상피세포암과 위선암이 병발한 3예를 경험하게 되었고 국내에 발표한 증례를 바탕으로 비교 분석하여 문헌고찰과 함께 보고한다.

식도암의 치료

양동훈 ( Dong Hoon Yang ),정훈용 ( Hwoon Yong Jung ) 대한소화기학회 2008 대한소화기학회지 Vol.52 No.6

Esophageal cancer is usually detected in the advanced stage due to its anatomical characteristics. Recently, early esophageal cancers are detected more frequently with the nationwide screening of digestive tract cancer and development of new endoscopic technology in Korea. From the treatment view point, esophageal cancer can be categorized into early, locally advanced resectable, locally advanced unresectable, and metastatic esophageal cancer. Traditionally, surgery has been the mainstay of treatment for resectable esophageal cancer. However, endoscopic resection can be another therapeutic option in selected early esophageal cancer cases. Although most studies with preoperative chemoradiotherapy and subsequent surgery in locally advanced resectable cancer could not demonstrate definite survival benefit, many authorities prefer this multimodality approach to surgery alone. Best supportive care is always necessary for those with unresectable esophageal cancer, and palliation for dysphagia can be considered according to the patients` status. For the best management of esophageal cancer, the development of diagnostic method for more accurate staging should be followed.

Mini-Array of Multiple Tumor-associated Antigens (TAAs) in the Immunodiagnosis of Esophageal Cancer

Qin, Jie-Jie,Wang, Xiao-Rui,Wang, Peng,Ren, Peng-Fei,Shi, Jian-Xiang,Zhang, Hong-Fei,Xia, Jun-Fen,Wang, Kai-Juan,Song, Chun-Hua,Dai, Li-Ping,Zhang, Jian-Ying Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.6

Sera of cancer patients may contain antibodies that react with a unique group of autologous cellular antigens called tumor-associated antigens (TAAs). The present study aimed to determine whether a mini-array of multiple TAAs would enhance antibody detection and be a useful approach in esophageal cancer detection and diagnosis. Our mini-array of multiple TAAs consisted of eleven antigens, p53, pl6, Impl, CyclinB1, C-myc, RalA, p62, Survivin, Koc, CyclinD1 and CyclinE full-length recombinant proteins. Enzyme-linked immunosorbent assays (ELISA) were used to detect autoantibodies against eleven selected TAAs in 174 sera from patients with esophageal cancer, as well as 242 sera from normal individuals. In addition, positive results of ELISA were confirmed by Western blotting. In a parallel screening trial, with the successive addition of antigen to a final total of eleven TAAs, there was a stepwise increase in positive antibody reactions. The eleven TAAs were the best parallel combination, and the sensitivity and specificity in diagnosing esophageal cancer was 75.3% and 81.0%, respectively. The positive and negative predictive values were 74.0% and 82.0%, respectively, indicating that the parallel assay of eleven TAAs raised the diagnostic precision significantly. In addition, the levels of antibodies to seven antigens, comprising p53, Impl, C-myc, RalA, p62, Survivin, and CyclinD1, were significantly different in various stages of esophageal cancer, which showed that autoantibodies may be involved in the pathogenesis and progression of esophageal cancer. All in all, this study further supports our previous hypothesis that a combination of antibodies might acquire higher sensitivity for the diagnosis of certain types of cancer. A customized mini-array of multiple carefully-selected TAAs is able to enhance autoantibody detection in the immunodiagnosis of esophageal cancer and autoantibodies to TAAs might be reference indicators of clinical stage.

Null Genotype of GSTT1 Contributes to Esophageal Cancer Risk in Asian Populations: Evidence from a Meta-analysis

Yi, Sheng-Ming,Li, Gui-Yuan Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.10

Background/Aims: Glutathione S-transferase T1 (GSTT1), a phase-II enzyme, plays an important role in detoxification of carcinogen electrophiles. Many studies have investigated the association between GSTT1 polymorphism and esophageal cancer risk in Asian populations, but its actual impact is not clear owing to apparent inconsistencies among those studies. Thus, a meta-analysis was performed to explore the effect of GSTT1 polymorphism on the risk of developing esophageal cancer. Methods: A literature search of PubMed, Embase, and Wanfang databases up to August 2012 was conducted and 15 eligible papers were finally selected, involving a total of 1,626 esophageal cancer cases and 2,216 controls. We used the pooled odds ratio (OR) with its corresponding 95% confidence interval (95%CI) to estimate the association of GSTT1 polymorphism with esophageal cancer risk. Subgroup analyses and sensitivity analyses were performed to further identify the association. Results: Meta-analysis of total studies showed the null genotype of GSTT1 was significantly associated with an increased risk of esophageal cancer in Asians (OR=1.26, 95%CI=1.05-1.52, $P_{OR}=0.015$, $I^2=42.7%$). Subgroup analyses by sample size and countries also identified a significant association. Sensitivity analysis further demonstrated a relationship of GSTT1 polymorphism to esophageal cancer risk in Asians. Conclusions: The present meta-analysis of available data showed a significant association between the null genotype of GSTT1 and an increased risk of esophageal cancer in Asians, particularly in China.

Efficacy of Vitamin and Antioxidant Supplements in Prevention of Esophageal Cancer: Meta-analysis of Randomized Controlled Trials

명승권,양효진 대한암예방학회 2013 Journal of cancer prevention Vol.18 No.2

Background: Observational epidemiological studies have shown that higher intakes of vitamins or antioxidants were inverselyassociated with the risk of esophageal cancer. However, randomized controlled trials (RCTs) have reported no preventive efficacyof vitamin or antioxidant supplements on esophageal cancer. This meta-analysis aimed to investigate the efficacy of vitamin andantioxidant supplements in the prevention of esophageal cancer as reported by RCTs. Methods: We searched PubMed, EMBASE, and the Cochrane Library in May 2013. Two authors independently reviewed andselected eligible articles based on predetermined selection criteria. Results: Of 171 articles searched from three databases and relevant bibliographies, 10 RCTs were included in the final analyses. In a fixed-effect meta-analysis of 10 trials, there was no efficacy of vitamin and antioxidant supplements in the prevention ofesophageal cancer (relative risk [RR], 1.04; 95% confidence interval [CI], 0.86-1.25; I2=0.0%). Also, subgroup meta-analysesshowed that vitamin and antioxidant supplements had no preventive efficacy on esophageal cancer both in the high risk (RR,1.04; 95% CI, 0.85-1.28; n=4) and non-high risk (RR, 1.01; 95% CI, 0.65-1.56; n=6) groups for esophageal cancer. Further,subgroup meta-analyses revealed no preventive efficacy on esophageal cancer by type of methodological quality and type ofvitamin and antioxidant supplements. Conclusions: Unlike observational epidemiological studies, this meta-analysis of RCTs suggests that there is no clinical evidenceto support the efficacy of vitamin and antioxidant supplements in the prevention of esophageal cancer.