Esophageal cancer: A serious threat to African-American men

University of Michigan Health SystemJun 13 2013

The nation's attention and research money has been focused on esophageal adenocarcinoma - the type of esophageal cancer that has become more common over the last few decades and is associated with obesity and acid reflux.

But another type of cancer of the esophagus is a serious threat to African-American men, especially if they drink and smoke.

University of Michigan gastroenterologists Anoop Prabhu, M.D., and Joel Rubenstein, M.D., working with Kenneth Obi, M.D., examined the risk of the disease and potential for screening among African-American men.

Their findings were presented during national Digestive Diseases Week.

Ten Things to Know about Esophageal Cancer and African-American Men

1.Esophageal cancer is the 8th most common cancer and the 6th most common cause of cancer deaths worldwide.
2.Drinking alcohol, smoking or chewing tobacco, being obese, having gastroesophageal reflux disease (GERD), or Barrett's esophagus can lead to esophageal cancer, and cancer risk rises with age.
3.The lifetime risk of esophageal cancer in the U.S. is 1 in 125 for men and 1 in 435 for women.
4.It's thought chronic irritation of the esophagus contributes to the cellular changes that lead to cancer. The two major types of esophageal cancer are associated with different risk factors.
5.Types of esophageal cancer are:
•Esophageal Adenocarcinoma (EAC) - The most common in the U.S. and affects primarily white men, and associated with long-standing symptoms of GERD. Cancer begins in mucus-secreting glands in the lower portion of the esophagus.
•Esophageal squamous cell carcinoma (ESCC)- The most prominent type worldwide and occurs most often in the middle of the esophagus. It is strongly associated with heavy use of alcohol and tobacco.
6.ESCC is twice as common among African-American men as white men, based on data from the U.S. Surveillance, Epidemiology and End Results program.
7.The incidence of ESCC in African American men who use both alcohol and tobacco rivals the incidence of EAC in white men with GERD, according to a model developed by the U-M researchers.
8.At age 65, the incidence of ESCC in African-American men who have used tobacco and alcohol was estimated to be 65 per 100,000 people compared to an incidence of esophageal adenocarcinoma in white men with GERD at that age of 45 per 100,000 people.
9.Last year, the National Institutes of Health spent $16.8 million on esophageal-cancer related research, and of that, less than $500,000 was spent specifically on ESCC.
10.The effectiveness of screening programs for ESCC in high risk groups should be developed and studied.