Esophageal cancer

The epidemiology of esophageal cancer has marked variations in different areas of the world. The two major types are squamous and adenocarcinoma, the latter entity has attracted much attention because of increasing prevalence in the Western nations. The major risk factors for adenocarcinoma include long-standing gastroesophageal reflux disease, Barrett’s metaplasia, obesity, and possibly ethnicity in view of the observation that it affects predominantly Caucasian men. Risk factors for squamous carcinoma include alcoholism and smoking. Manifestations include dysphagia to solids and liquids, weight loss, and aspiration. Diagnosis requires upper endoscopy and target biopsies. Staging requires endoscopic ultrasound and CT imaging of chest and abdomen. Management includes surgery, chemotherapy, and chemoradiation, based on location, stage and type of cancer, in addition to age and comorbidity.