Explore the vast range of titles available.

Esophageal squamous cell carcinoma (ESCC) shows remarkable variation in incidence that is not fully explained by known lifestyle and environmental risk factors. It has been speculated that an unknown exogenous exposure(s) could be responsible. Here we combine the fields of mutational signature analysis with cancer epidemiology to study 552 ESCC genomes from eight countries with varying incidence rates. Mutational profiles were similar across all countries studied. Associations between specific mutational signatures and ESCC risk factors were identified for tobacco, alcohol, opium and germline variants, with modest impacts on mutation burden. We find no evidence of a mutational signature indicative of an exogenous exposure capable of explaining differences in ESCC incidence. Apolipoprotein B mRNA-editing enzyme, catalytic polypeptide-like (APOBEC)-associated mutational signatures single-base substitution (SBS)2 and SBS13 were present in 88% and 91% of cases, respectively, and accounted for 25% of the mutation burden on average, indicating that APOBEC activation is a crucial step in ESCC tumor development. The incidence of esophageal squamous cell carcinoma varies significantly across different geographical regions. Mutational signature analysis of tumors sampled from high- and low-incidence areas suggests that these variations may not be explained by mutagenic exposures.

Despite evidence linking cadmium (Cd) to poor cancer outcomes, its association with quality of life in esophageal squamous cell carcinoma (ESCC) patients remains unexplored. This study aimed to investigate the association. This prospective cohort analysis includes 414 newly diagnosed ESCC patients with a 6.5-year follow-up. The EORTC QLQ-C30 and EORTC QLQ‐OES18 were used to assess health-related quality of life (HRQoL). The QoLR package was used to calculate the HRQoL scores and determine time to deterioration(TTD) events. The effect of plasma Cd level on the HRQoL was assessed using Cox regression analysis. In the longitudinal TTD analysis, after controlling for potential confounders (age, gender, tumor location, clinical/pathological stage, and treatment modalities), higher plasma Cd levels were consistently associated with a significantly increased risk of deterioration in emotional functioning( HR  = 1.466, 95% CI :1.079–1.993), eating problems( HR  = 1.440, 95% CI : 1.054–1.968), choking when swallowing( HR  = 1.637, 95% CI : 1.194–2.244), and trouble with taste( HR  = 1.525, 95% CI : 1.093–2.128). These associations remained robust after adjustment for lifestyle and socioeconomic factors and were validated by bootstrap resampling analysis. Plasma Cd level may be a contributing factor to the deterioration of multiple HRQoL indicators.

Background Gastroesophageal junction carcinoma (GEJC) and esophageal squamous cell carcinoma (ESCC) are increasing in Australia and other Western countries. We aimed to investigate past trends and predict the future direction of GEJC and ESCC cases. Methods Data on GEJC and ESCC were extracted from the Australian Cancer Database, and the National Mortality Database for the Australian states of Victoria, Queensland, Tasmania, and the Australian Capital Territory. The new number of cases were predicted up to 2039 by fitting a least squares linear regression using the Australian incidence rates trend from 2009 to 2018. Past trends were analyzed for prevalence and mortality. Kaplan-Meier curves generated the survival trend for up to 10 years. Results Between 2009 and 2018, the overall incidences of GEJC showed an increasing trend (annual change [β 1 ] = 0.87, P  < 0.05). For GEJC, the rates of incidence, prevalence, and mortality were higher in men (β 1  = 1.86, 95% CI: 1.29–2.43, P  < 0.05; β 1  = 14.45, 95% CI: 12.93–15.98, P  < 0.05; β 1  = 1.04, 95% CI: − 0.68 to 2.76, P  = 0.195, respectively) than in women. By 2039, it is estimated that 6 in 100,000 population will be newly diagnosed with GEJC. Notably, the rate of new GEJC cases decreased in women during the study period (β 1 =–0.08, 95% CI: − 0.39 to 0.24, P  = 0.596). For ESCC, the incidence rate increased, albeit at a slower rate compared with GEJC (β 1  = 0.87, 95% CI: 0.6–1.15, P  < 0.05; β 1  = 0.03, 95% CI: − 0.28 to 0.34, P  = 0.805, respectively). New cases of ESCC in men declined (β 1 =–0.03, 95% CI: − 0.46 to 0.4, P  = 0.884). By 2039, it is predicted that 2 in 100,000 people will be newly diagnosed. The 10-year survival rate for GEJC and ESCC was low (11% and 20%, respectively), while the survival rate for women was relatively higher than for men. Conclusion The incidence, prevalence, and mortality would be predicted to increase in 2039 if there were no significant changes in risk factors, diagnosis, treatment, and management compared with 2009–2018. Strategies to identify early signs and enable earlier diagnosis and early and new treatment options are essential in GEJC and ESCC.

Esophageal cancer (EC) continues to be a significant global health concern, with two main subtypes: esophageal squamous cell carcinoma and esophageal adenocarcinoma. Prevention and changes in etiology, improvements in early detection, and refinements in the treatment have led to remarkable progress in the outcomes of EC patients in the past two decades. This seminar provides an in‐depth analysis of advances in the epidemiology, disease biology, screening, diagnosis, and treatment landscape of esophageal cancer, focusing on the ongoing debate surrounding multimodality therapy. Despite significant advancements, EC remains a deadly disease, underscoring the need for continued research into early detection methods, understanding the molecular mechanisms, and developing effective treatments.

INTRODUCTION:Prediction models for esophageal squamous cell carcinoma (ESCC) need to be proven effective in the target population before they can be applied to population-based endoscopic screening to improve cost-effectiveness. We have systematically reviewed ESCC prediction models applicable to the general population and performed external validation and head-to-head comparisons in a large multicenter prospective cohort including 5 high-risk areas of China (Fei Cheng, Lin Zhou, Ci Xian, Yang Zhong, and Yan Ting).METHODS:Models were identified through a systematic review and validated in a large population-based multicenter prospective cohort that included 89,753 participants aged 40-69 years who underwent their first endoscopic examination between April 2017 and March 2021 and were followed up until December 31, 2022. Model performance in external validation was estimated based on discrimination and calibration. Discrimination was assessed by C-statistic (concordance statistic), and calibration was assessed by calibration plot and Hosmer-Lemeshow test.RESULTS:The systematic review identified 15 prediction models that predicted severe dysplasia and above lesion (SDA) or ESCC in the general population, of which 11 models (4 SDA and 7 ESCC) were externally validated. The C-statistics ranged from 0.67 (95% confidence interval 0.66-0.69) to 0.70 (0.68-0.71) of the SDA models, and the highest was achieved by Liu et al (2020) and Liu et al (2022). The C-statistics ranged from 0.51 (0.48-0.54) to 0.74 (0.71-0.77), and Han et al (2023) had the best discrimination of the ESCC models. Most models were well calibrated after recalibration because the calibration plots coincided with the x = y line.DISCUSSION:Several prediction models showed moderate performance in external validation, and the prediction models may be useful in screening for ESCC. Further research is needed on model optimization, generalization, implementation, and health economic evaluation.

Purpose This updated umbrella review aimed to evaluate the evidence regarding the associations between dietary factors and the risks of esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC). Methods The PubMed, Embase, Cochrane Library, and Web of Science databases were searched to identify relevant studies. The quality of the included meta-analyses was evaluated using A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2). For each association, the number of cases, random effects pooled effect size, 95% confidence intervals (CIs), heterogeneity, 95% prediction interval (PrI), small-study effect, and excess significance bias were recalculated to determine the evidence level. Results We identified 33 meta-analyses describing 58 dietary factors associated with ESCC and 29 meta-analyses describing 38 dietary factors associated with EAC. There was convincing evidence regarding the association of 2 dietary factors (areca nut and high alcohol) with the risk of ESCC. There was highly suggestive evidence regarding the association of only 1 dietary factor (healthy pattern) with the risk of ESCC. There was suggestive evidence regarding the association of 11 dietary factors with the risk of ESCC, including fruit, citrus fruit, vegetables, pickled vegetables, maté tea, moderate alcohol, hot beverages and foods, hot tea, salt, folate, and vitamin B 6 . There was convincing evidence regarding the association of one dietary factor (vitamin B 6 ) with the risk of EAC. There was suggestive evidence regarding the association of 4 dietary factors with the risk of EAC, including processed meat, dietary fibre, carbohydrate, and vitamin B 12 . The convincing evidence regarding the associations between dietary factors and the risks of ESCC and EAC remained robust in sensitivity analyses. Conclusions This umbrella review highlighted convincing evidence regarding the associations of areca nut and high alcohol with a higher risk of ESCC. Additionally, an association between vitamin B 6 and a decreased risk of EAC was observed. Further research is needed to examine the dietary factors with weak evidence regarding their associations with ESCC and EAC.

Background Recent studies have indicated that the incidence of esophageal cancer has declined in the past decade in the U.S. However, trends in the incidence and survival have not been thoroughly examined. Methods Data from 46 063 patients with esophageal cancer between 1973 and 2015 were collected from the Surveillance, Epidemiology, and End Results database. The trends in the age‐adjusted incidence and survival were analyzed using joinpoint regression models. Results The age‐adjusted incidence of esophageal cancer increased from 5.55 to 7.44 per 100 000 person‐years between 1973 and 2004. Later, it decreased at an annual percentage change of 1.23%. In the last 40 years, the strong male predominance increased slightly. Importantly, the percentage of patients with localized stage of squamous cell cancer decreased. It was observed that the incidence of esophageal squamous cell carcinoma declined since 1986, while the incidence of esophageal adenocarcinoma sharply increased since 1973 and surpassed the rate of squamous cell cancer, mainly due to the increase in the incidence among men. Consistently, the estimated 40‐year limited‐duration prevalence of esophageal adenocarcinoma was higher than that of esophageal squamous cell carcinoma. Additionally, we observed a modest but significant improvement in survival during the study period. Conclusion The incidence of esophageal squamous cell carcinoma has decreased significantly over the past four decades in the U.S., while the incidence of adenocarcinoma has increased, particularly among men. Overall, the long‐term survival of patients with esophageal cancer is poor but it has improved over the past decades, especially for the localized disease. Key points Significant findings of the study The incidence of esophageal cancer has decreased at an annual percentage change of 1.23% since 2004. The incidence of esophageal adenocarcinoma has sharply increased since 1973 and surpassed the rate of squamous cell cancer, mainly due to the increase in the incidence among men. What this study adds There has been a shift in the prevalence of esophageal cancer histological subtypes over the past decades in the U.S. We found that the incidence of esophageal squamous cell carcinoma has continued to decrease, while the esophageal adenocarcinoma rate has continued to increase.

The effect of body mass index (BMI) on esophageal and gastric carcinogenesis might be heterogeneous, depending on subtype or subsite. However, findings from prospective evaluations of BMI associated with these cancers among Asian populations have been inconsistent and limited, especially for esophageal adenocarcinoma and gastric cardia cancer. We performed a pooled analysis of 10 population‐based cohort studies to examine this association in 394,247 Japanese individuals. We used Cox proportional hazards regression to estimate study‐specific hazard ratios (HRs) and 95% confidence intervals (CIs), then pooled these estimates to calculate summary HRs with a random effects model. During 5,750,107 person‐years of follow‐up, 1569 esophageal cancer (1038 squamous cell carcinoma and 86 adenocarcinoma) and 11,095 gastric (728 cardia and 5620 noncardia) cancer incident cases were identified. An inverse association was observed between BMI and esophageal squamous cell carcinoma (HR per 5‐kg/m2 increase 0.57, 95% CI 0.50–0.65), whereas a positive association was seen in gastric cardia cancer (HR 1.15, 95% CI 1.00–1.32). A nonsignificant and significant positive association for overweight or obese (BMI ≥25 kg/m2) relative to BMI <25 kg/m2 was observed with esophageal adenocarcinoma (HR 1.32, 95% CI 0.80–2.17) and gastric cardia cancer (HR 1.24, 95% CI 1.05–1.46), respectively. No clear association with BMI was found for gastric noncardia cancer. This prospective study—the largest in an Asian country—provides a comprehensive quantitative estimate of the association of BMI with upper gastrointestinal cancer and confirms the subtype‐ or subsite‐specific carcinogenic impact of BMI in a Japanese population. The impact of BMI on upper gastrointestinal cancer by subtype or subsite among Asians is inconclusive. Using data from 10 large‐scale population‐based cohort studies, we evaluated the association between BMI and upper gastrointestinal cancers for 394,247 Japanese individuals. With 1038 esophageal squamous cell carcinoma, 86 esophageal adenocarcinoma, 728 gastric cardia cancer, and 5620 gastric noncardia cancer cases, we confirmed the subtype‐ or subsite‐specific carcinogenic impact of BMI in an Asian population.

Pharyngeal squamous cell carcinoma has been linked to later squamous cell carcinoma of the esophagus, but it is unclear if risks are similar to that of Barrett’s esophagus and would justify routine gastroscopy surveillance. Data on pharyngeal and esophageal cancers in 1980–2016 were retrieved through histopathology reports from Sweden’s 28 pathology departments and linked to national population-based healthcare registers. We calculated hazard ratios (HRs) for esophageal cancer and death in patients with pharyngeal carcinoma compared to a matched general population, and in a secondary analysis also compared to siblings of patients. We identified 1055 adults with pharyngeal cancer without prior or concomitant cancer. 78 % were men and median age at diagnosis of pharyngeal cancer was 64 years. During a median follow-up of 2.5 years four (0.4 %) patients developed esophageal squamous cell carcinoma, equal to 1 in 263 patients (HR = 14.3; 95 % CI = 1.6–132.3). In a competing risk analysis, the risk estimate for ESCC dropped and did not attain statistical significance (subdistribution HR=1.9 (95 % CI=0.7–5.2)). Some 855 patients (81 %) died during follow-up, representing a 7.7-fold increased risk of death among patients with pharyngeal cancer (Cox regression: HR=7.7; 95 % CI = 6.8–8.6). The yearly risk of developing esophageal squamous cell carcinoma was 0.07 %. This is lower than in Barrett’s esophagus and argues against long-term endoscopic surveillance among patients with pharyngeal cancer. 3 •1 in 263 patients with squamous cell carcinoma in the pharynx develop ESCC in the Swedish population.•A competing risk regression model, which provides subdistribution hazard ratios, was appropriate given a high mortality rate.•Routine gastroscopy surveillance for ESCC is not indicated among patients with PSCC due to the low annual ESCC risk.

Toxic elements exposure and imbalance in essential element homeostasis remain incomprehensive in esophageal squamous cell carcinoma (ESCC) carcinogenesis, especially in tumor progression. To reveal the toxic and essential elements inside body associated with ESCC occurrence, aggressive features and outcomes, whole blood concentrations of eight trace elements were quantified in 150 ESCC cases and 177 controls using inductively coupled plasma-mass spectrometry (ICP-MS). Concentrations of cadmium (Cd), lead (Pb), chromium (Cr), copper (Cu), arsenic (As), and selenium (Se) showed significant differences between the case and control subjects. The restricted cubic spline (RCS) analysis showed As, Zinc (Zn), and manganese (Mn) was linked with ESCC risk in a U-shaped pattern, whereas an inverted U-shaped curve for Cd (all P -non-linear < 0.05). Contrary to Se, the elements Pb, Cr and Cu were positively associated with ESCC risk. By Bayesian Kernel Machine Regression models, the mixtures of the eight trace elements were found to be significantly associated with ESCC risk and metastasis, with Cr, Mn, Cu, Zn, and Pb having a PIP of 1.000 for occurrence risk and Mn being the main contributor for metastatic risk (PIP = .6570). The weighted quantile sum (WQS) model consistently showed that Cu, Cr, Pb, and Cd ranked as the top four positive elements for ESCC risk. Multivariable logistic regression analysis indicated Pb and As were positively associated with tumor invasion (adjusted OR 3.024 [1.053–8.689]; OR 4.385 [1.271–15.126], respectively), whereas Se had the opposite trend (adjusted OR 0.261 [0.074–0.927). Patients with high Cr, Mn, or Pb showed worse overall survival (OS), and high Mn were linked to inferior progression-free survival (PFS) (all P  < 0.05). Zn and Pb, and Mn and Cu were identified as independent prognostic factors for OS and PFS, respectively. This study suggests trace element disbalance in human body contributes to the risk of onset and progression of ESCC, especially in a high-incidence region. Further epidemiological and experimental studies were needed to clarify the probable pathogenic processes underpinning the potential link between trace element mixtures and ESCC.