A quiet epidemic - men's risk of oesophageal cancer is triple women's risk
Men are almost three times more likely to get oesophageal cancer than women – one of the biggest gender gaps in cancer rates – according to figures1 released from Cancer Research UK.
And this difference seems to be caused by one particular type of oesophageal cancer – adenocarcinoma – which is linked to obesity as well as long-term acid heartburn or indigestion2.
Oesophageal cancer is the ninth most common cancer in the UK. The latest figures show more than 5,600 men in the UK develop oesophageal cancer every year compared to 2,800 women. This equates to rates of almost 15 in 100,000 men getting the disease, compared to around 5 in 100,000 women.
There are two main types of oesophageal cancer, adenocarcinoma and squamous cell carcinomas. Obesity, tobacco and long term acid reflux increase the risk of adenocarcinoma, while tobacco, alcohol and a diet low in fruit are the most common risk factors for squamous cell carcinoma.
And these Cancer Research UK statistics show that, in England, adenocarcinomas in men have been rising steadily from 1,600 cases (or 6.2 per 100,000 men) in 1997, to over 3000 cases (or 9.4 per 100,000) in 20103.
For women adenocarcinomas have also increased, though more slowly to around 800 cases (or 1.8 per 100,000 women)3.
By comparison squamous cell carcinoma rates in both men and women haven’t increased. There were around 900 and 1000 cases diagnosed each year in men and women respectively in 20104.
Mr Tim Underwood, an oesophageal surgeon and researcher at the University of Southampton, said: “These figures show a worrying number of oesophageal cancers being diagnosed each year, particularly among men.
“Diagnosing the disease earlier is key to improving the chances of survival. Food getting stuck when you swallow and persistent heart burn are not normal. If this is happening to you, you need to see your GP. The vast majority of people won’t have anything seriously wrong with them, but it’s important to get checked out. If left untreated acid reflux – often called heartburn – can damage cells of the oesophagus leading to a condition called Barrett’s oesophagus which in turn can be a precursor of oesophageal cancer.
“And there’s still so much more we need to understand about the disease. One of the most important research projects is unravelling the genetic code of oesophageal cancer. British scientists, funded by Cancer Research UK’s Catalyst Club, are working on this as part of the International Cancer Genome Consortium (ICGC).
“To raise the money to fund this vital research, I’m going to be running the New York Marathon for the Catalyst Club project in November. My fellow team of runners and I have pledged to raise £100,000.”
Donna Sharland, an oesophageal and gastric cancer nurse at the University of Southampton and part of the marathon team, said: “Every day I ask patients to give far more than they ever thought they could, so I feel it is my turn to step out of the comfort zone, and push myself to see how much reserve I have. My patients don’t have the luxury of being able to stay in their comfort zone. They have to trust me and the team, and dig in for the hard slog.”
Mr Jim Byrne, a consultant oesophageal surgeon, at the University of Southampton, and part of the marathon team, said: “My father in law has also just been through his own cancer marathon – he is undergoing treatment for a recurrence for bladder cancer. As a marathon runner himself, it seems right to do this marathon in part as a tribute to him.”
Dr Rebecca Fitzgerald, a Cancer Research UK scientist at the University of Cambridge, said: “Oesophageal cancer is on the rise, and sadly the outlook for this disease remains poor. But we’re doing all we can to buck this trend. The chances of surviving oesophageal cancer are greatly improved when it is diagnosed at an early stage.
“I’m working on a trial looking to see whether a technique called cytosponge or ‘sponge on a string’, could help doctors diagnose the very early pre-cursors of oesophageal cancer so that they can be treated. We hope this may have the potential to cut the number of people who develop oesophageal cancer in the future.”
Patron of Cancer Research UK’s Catalyst Club, business entrepreneur James Caan, said: “The worrying increase in oesophageal cancer in men is a key reason why the Catalyst Club’s support for the International Cancer Genome Consortium (ICGC)’s vital work into unravelling the genetics behind the disease is so important.
“It’s fantastic that Tim Underwood and his team have taken on the challenge of running the New York Marathon and raising an ambitious £100,000 for this incredible research which will help improve survival rates.”
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Notes to Editor
2 Long term indigestion or acid reflux could be a symptom of oesophageal cancer or Barrett's oesophagus, where the cells that line the oesophagus(?) change shape (metaplasia). Barrett’s oesophagus is also a recognised risk factor for cancer of the oesophagus.
3 In England for males, European Age Standardised incidence rates for adenocarcinoma increased by 52% from 6.2 per 100,000 men in 1995-1997 to 9.4 in 2008-2010. The rise is smaller for females in England, with rates increasing by 32% overall from 1.4 per 100,000 women in 1995-1997 to 1.8 in 2008-2010.
4 The two main types of oesophageal cancer are adenocarcinoma and squamous cell carcinoma. These made up 83% of oesophageal cancer cases in 2008-2010 (55% for adenocarcinoma and 28% for squamous cell carcinoma). The remaining 17% of cases are mainly cases where the exact type of cancer could not be determined.