Risk factors and prevention of esophageal cancer

摘要: Esophageal cancer is the eighth most common in world, consisting of two major histological types: squamous cell carcinoma (dominant globally) and adenocarcinoma (rapidly increasing incidence Western world during last decades). Established risk factors for are gastroesophageal reflux symptoms, obesity tobacco smoking, whereas mainly associated with smoking excessive alcohol intake. predominantly affects men; gender difference cases entirely explained by higher prevalence men, but striking 7:1 sex ratio remains unexplained. carries a very poor prognosis despite efforts to improve survival overall 5-year rate still less than 10%, emphasizing need preventive factors. This thesis focuses on etiology esophageal unexplained male predominance adenocarcinoma. The first paper investigates differences factor profiles between women men as possible explanation cardiac was based nationwide population-based case-control study all newly diagnosed (n=451) corresponding controls (n=816) Sweden 1994-1997. Contradictory hypothesis, point odds ratios (OR) did not indicate any weaker association established reflux, (4.6, 10.3, 5.3, respectively) compared (3.4, 5.4, 2.8, respectively). Protective such high intake fruit vegetables or infection Helicobacter pylori showed no stronger protective effect women. Thus, exposure known do seem explain cardia second investigated if United Kingdom population Investigations were identical questionnaires filled out random sample English (n=3633) Swedish (n=1483) populations. symptoms significantly (OR 2.0, 95% CI 1.6-2.4 OR 1.8, 1.5-2.1), suggesting that at least partly due well-established third why surgical intervention does provide protection against All among antireflux operated patients 1965-2006 identified matched from same cohort. Recurrence after surgery 3.1, 1.5-6.3), while BMI, type appeared be lesser importance. Recurrent can lack endoscopic surveillance might an option these patients. fourth human papillomavirus (HPV) tumor location esophagus. hypothesis oral route transmission HPV oropharyngeal carcinoma. Available material carcinomas Stockholm County 1999-2006 collected examined presence using multiplex polymerase chain reaction (PCR) Luminex. No increased occurrence DNA observed located proximal more distal part (10%) low, biologically active, p16 data.