Oesophageal carcinoma has an incidence of 9.6/100 000 and a very poor prognosis – 5 year survival is less than 10%.
2/3rds of cases are in over 65s.
Presentation tends to be dysphagia.
In the UK the commonest type is adenocarcinoma.
Identified risk factors for oesophageal adenocarcinoma include:
- Reflux/Barrett’s oesophagus
- Hiatus hernia
- Obesity
- Diet lacking in fruit and vegetables
- Fatty diet
- Smoking
- Male gender
Worldwide the commonest type of oesophageal cancer is squamous cell. It is especially common in China and Iran.
Identified risk factors for oesophageal squamous cell carcinoma include:
- Diet lacking in fruit and vegetables
- Fatty diet
- Smoking
- Male gender
- Alcohol
- Achalasia
- Low socioeconomic status
- Plummer-Vinson syndrome
- Nutritional deficiencies – zinc, magnesium, riboflavin, nicotinic acid
Adenocarcinomas are usually located in the distal third of the oesophagus
(94%) while squamous cell carcinomas are usually found in the middle and upper third.
Management is oesophagectomy + ?chemo/radiotherapy
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