Scientists have found a worrying rise in a particular variant of cancer

New research has found that the incidence of intestinal cancer in adults between the ages of 45 and 64 has almost doubled.

According to the researchers, the data indicate that it is urgent to perform an endoscopic screening earlier

Esophageal cancer is a type of cancer that develops in the esophagus, which is a long, empty tube that connects the throat to the stomach. Your esophagus helps transport the food you eat to your stomach, where it is digested. Esophageal cancer usually begins in cells that line the inside of the esophagus. However, it can occur at any point in the esophagus.

Esophageal cancer is the leading cause of cancer death worldwide. Disease rates vary depending on where you live. Tobacco and alcohol consumption, as well as certain dietary practices and obesity, may be associated with an increased risk of bowel cancer.

According to a database study of five million patients presented at Digestive Disease Week 2022, adults between the ages of 45 and 64 nearly doubled the prevalence of bowel cancer and between 2012 and 2019 a 50% increase in Barrett’s esophageal cancer.

“This large increase in prevalence should be of concern to physicians, and we should consider screening more middle-aged patients if they are at higher risk for esophageal cancer,” said Bashar J. Qumseya, MD, MPH, FASGE, lead author. associate professor of study and medicine and head of endoscopy at the University of Florida, Gainesville. “When we look at the growing prevalence of any type of cancer, we should ask whether it is only due to a better screening or a real increase in the prevalence of the disease. In our study, it is due to the latter.”

The researchers studied the rate of esophagogastroduodenoscopy (EGD) over this time period and found no evidence of an increase that could explain the prevalence data. An EGD is a diagnostic procedure that examines the first part of the small intestine, stomach, and small intestine (duodenum).

Esophageal cancer and Barrett’s esophagus are the most common in older white men, according to the study, and are most prevalent in those over 65 years of age. However, the researchers found that the incidence of cancer between the ages of 45 and 64 doubled from 49 to 49 per 100,000, and the frequency of Barrett’s esophagus increased by approximately 50% from 304 to 466 per 100,000 people.

Esophageal cancer, which is usually detected by endoscopy, is a silent killer that often has minimal symptoms until it progresses. Barrett’s esophagus, the leading cause of esophageal adenocarcinoma, which begins in the gland cells of the esophageal lining, is mainly caused by chronic diseases.[{” attribute=””>acid reflux. Other risk factors include advanced age, male sex, obesity, smoking, and alcohol consumption.

Dr. Qumseya said that middle-aged patients with multiple risk factors would benefit from earlier and/or more frequent screening, comparing it to the benefit of earlier colorectal cancer screening. “Many patients in the U.S. now have colonoscopies starting at age 45, so conducting an endoscopy at the same time, among those with multiple risk factors, could help capture more patients with Barrett’s esophagus and esophageal cancer,” he said.

“From other analyses we have conducted with this dataset, we know that even patients with four or more risk factors for esophageal cancer are not having endoscopies,” he added. “So, from both the patient and provider perspective, we can do better.”

The study was a cross-sectional analysis of electronic health record (EHR) data from the OneFlorida Clinical Data Research Network, which covers more than 40 percent of Florida residents.

Researchers analyzed records by three age categories, 18 to 44, 45 to 64, and over 65. Further analysis of the database is ongoing, and the final results should be ready in the next six months.

Dr. Qumseya noted several limitations of the study: it covered only adults living in Florida, so is not necessarily representative of the U.S. population. It was not a randomized controlled trial that followed one group of patients over time. In addition, as with any database, there could be problems with the data itself. The EHRs analyzed were of patients who visited hospitals or doctors’ offices, so the database does not indicate whether they already had a disease at the time of that visit or whether the condition had resolved.

In the final analyses, the research team plans to revisit the database to try to differentiate between the two types of esophageal cancer – esophageal adenocarcinoma, which usually affects the lower esophagus, and squamous cell carcinoma, which affects the upper esophagus.

Reference: “Alarming increase in prevalence of esophageal cancer and Barrett’s esophagus in middle-aged patients: findings from a statewide database of over five million patients” by Bashar J. Qumseya et al., 23 May 2022. 

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