Rise in Esophageal Cancer in Young Adults. Is Lifestyle to Blame?

NEW YORK (Reuters Health) – Over the past 30 years in the Netherlands, the incidence of esophageal adenocarcinoma (EAC) has tripled in adults younger than age 50, from 0.34 cases per 100,000 in 1989 to 0.92 per 100,000 in 2018, new research indicates.

The rising trend was most prominent in young women, with an average annual increase of 3%, twice that seen in males at 1.5%, said lead author Dr. Ali Al-Kaabi, from Radboud University Medical Center in Nijmegen, in reporting the results at a press briefing during UEG Week Virtual 2021.

The study also shows that patients younger than age 50 were more likely to present with advanced-stage disease compared to older adults, “which may be explained by longer patient delays in younger people,” Dr. Al-Kaabi noted.

However, younger patients are more likely to undergo multimodality treatments and relative survival for the younger age group rose accordingly in comparison to older patients, he noted.

The findings are based on registry data for 59,864 adults with esophageal cancer.

Increased rates of esophageal adenocarcinoma could reflect changes in lifestyle-related risk factors for the disease, with rises in unhealthy habits including smoking, poor diet, and reduced physical activity, the study team noted.

“We know the disease is associated with Barrett’s esophagus, which is a premalignant condition in the lower end of the esophagus. Gastroesophageal reflux (acid reflux), obesity and smoking are also important risk factors for esophageal adenocarcinoma. We also know that rates of these risk factors have all increased in young adults over the past 30 years,” Dr. Al-Kaabi said in a conference statement.

He noted that symptoms for esophageal cancer can be difficult to spot and may be confused with other gastrointestinal symptoms. These include trouble swallowing, feeling or being sick, heartburn, and indigestion.

“Based on these study findings, it is important that adults under 50 are aware of these esophageal cancer symptoms to enable earlier diagnosis and a higher chance of survival. This is especially important in high-risk groups, including those that smoke, those with obesity, or those that have high levels of alcohol consumption,” Dr. Al-Kaabi said in the statement.

Dr. Axel Dignass, UEG president and briefing moderator, with Agaplesion Markus Krankenhaus in Germany, said this study is important as it “brings to mind that esophageal cancer is not something of the very old but is also occurring in younger people and increasing in younger people.”

SOURCE: https://bit.ly/3DlX4ER UEG Week Virtual 2021, presented October 5, 2021.

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