Esophageal Carcinoma

Esophageal adenocarcinoma has become the predominant type of esophageal cancer in North America and Europe, and gastroesophageal reflux disease (GERD) and obesity are the main risk factors. Barrett's esophagus, the recognized precursor lesion, can be detected by means of endoscopic screening, which is followed by treatment of precancerous lesions and monitoring for the development of neoplastic progression. Esophageal squamous-cell carcinoma remains the predominant esophageal cancer in Asia, Africa, and South America and among African Americans in North America. Alcohol and tobacco use are the main risk factors, and esophageal squamous dysplasia is the precursor lesion. The 5-year survival rate for patients with esophageal cancer, although generally poor, has improved during the past decade, and long-term survival is increasingly possible for patients with early or locally advanced disease. This review discusses the epidemiologic aspects and pathogenesis of these two esophageal cancers, as well as prevention and therapy, focusing on recent advances. Copyright © 2014 Massachusetts Medical Society. All rights reserved.