A study looking at the causes of oesophageal cancer (MOSES)

Cancer type:

Oesophageal cancer

Status:

Results

Phase:

Other

This study was done to find out more about the causes and possible risk factors of oesophageal cancer.

It was open for people to join between 2006 and 2008. The team have published several papers in medical journals.

More about this trial

When this study was done, the number of people with a type oesophageal cancer called adenocarcinoma was higher in the UK than other countries, and increasing. The research team wanted to try and find out why.

Earlier studies had suggested certain things can increase someone’s risk of oesophageal cancer, including:

acid indigestion or reflux
being overweight
smoking
drinking too much alcohol
a poor diet

The aim of this study was to find out more about which factors increase the risk of developing oesophageal adenocarcinoma or Barrett’s oesophagus related adenocarcinoma. They hoped this could help doctors advise people on how to reduce their risk.

Summary of results

Study design
This study was for people who’d recently been diagnosed with oesophageal adenocarcinoma. The research team interviewed them to ask them about their lifestyle and dietary habits. They also collected medical information and took blood samples.

The team also interviewed people who didn’t have oesophageal cancer. These were the controls.

Results
More than 700 people joined this study:

207 people who had oesophageal cancer
224 people who had an inflamed oesophagus caused by acid reflux (oesophagitis)
283 people who didn’t have cancer or an inflamed oesophagus

The research team interviewed everyone who took part to find out more about their lifestyle and dietary habits. They also took blood samples to look for genetic changes.

They then analysed the results to look for anything that may be linked to the development of oesophageal cancer.

Diet and lifestyle factors
They found a number of things may increase the risk of developing oesophageal cancer. These include:

acid reflux, especially if it wakes you at night
larger waist size
increased weight and body mass index (BMI)
a diet high in red meat
a diet high in salt
smoking
drinking tea

They also found that a diet high in fruit and vegetables may decrease the risk of oesophageal cancer.

They couldn’t find a link between oesophageal cancer and some foods and drink in the diet. These include:

white meat
fish
coffee

Genetic analysis
The team worked with other researchers to look for genetic changes that may increase the risk of developing Barrett’s oesophagus. This is not cancer but can develop into cancer over many years.

They think there are probably many gene changes that each have a small effect on cancer risk. And a smaller number of gene changes that have a larger effect. This includes changes in or near genes called FOXFI, GDF5, TBX5 and ALDH1A2.

They also found that genes linked to increased obesity may increase the risk of Barrett’s oesophagus.

These results, combined with results of other trials, will help researchers understand more about the risk of developing oesophageal cancer.

More detailed information
There is more information about this research in the references below.

Please note, the articles we link to below are not in plain English. They have been written for healthcare professionals and researchers.

The Effect of Body Mass Index, and Waist Circumference on the Development of Oesophageal Adenocarcinoma.
S Cooper and others.
Gastroenterology, 2010. Volume 138, issue 5. Abstract W1880.

The Effect of Diet on the Development of Oesophageal Adenocarcinoma.
S Cooper and others.
Gastroenterology, 2010. Volume 138, issue 5. Abstract W1877.

The Effect of Smoking and Alcohol Consumption on the Development of Oesophageal Adenocarcinoma.
S Cooper and others.
Gastroenterology, 2010. Volume 138, issue 5. Abstract W1878.

Gastro-oesophageal reflux symptoms and the development of oesophageal adenocarcinoma.
S Cooper and others
Gut, 2010. Volume 59, issue supplement 1. Abstract PWE-073.

Common variants at the MHC locus and at chromosome 16q24.1 predispose to Barrett's esophagus
The Esophageal Adenocarcinoma Genetics Consortium
Nature Genetics, 2012. Issue 44, pages 1131 – 1136.

Polymorphisms Near TBX5 and GDF7 Are Associated With Increased Risk for Barrett’s Esophagus
C Palles and others
Gastroenterology, 2015. Volume 148, issue 2, pages 367 - 378.

Where this information comes from
We have based this summary on the information in the articles above. These have been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in medical journals. We have not analysed the data ourselves.