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Adenocarcinoma of the Esophagus and Gastric Cardia - Landmark Studies
The contents of this section were published in 2003 as part of SEER's 30th Anniversary celebration.
Studies in the 1980s of esophageal and gastric cancers used data from SEER registries to describe histologic and epidemiological characteristics. These studies described different patterns by age, sex, and race (black/white) and helped to define a set of squamous cell carcinomas and adenocarcinomas that were increasing in the population. Concomitant with similar observations in European countries, an analysis of 1973-1987 cancer incidence data from nine SEER registries showed steadily rising rates of adenocarcinomas of the esophagus and gastric cardia. The rate of increase surpassed that of any other cancer for the time period, including non-Hodgkin's lymphoma and lung cancer. To learn more about these cancers, a multicenter case-control study was conducted using cancer registry data on recently diagnosed cases in Connecticut, New Jersey, and western Washington state. This study revealed that smoking is a major risk factor for these adenocarcinomas, accounting for approximately 40 percent of cases. Later studies looked into the possible effects of medications on these cancers, using interviews with patients and controls from the same registry areas as the previous study. Following on the finding that regular users of nonsteroidal anti-inflammatory drugs (NSAIDS) are at reduced risk of colon cancer, investigators found that regular users of either aspirin or other NSAIDs are also at reduced risk of adenocarcinoma of the esophagus and gastric cardia. A second study examined a number of common medications that are known to promote gastroesophageal reflux by relaxing the lower esophageal sphincter (LES). The investigators found that people who took asthma drugs containing theophylline or beta-agonists were at higher risk for esophageal adenocarcinoma, and the risk increased with duration of use. However, the study also provided the reassuring finding that use of other LES-relaxing drugs, specifically calcium channel blockers, is not likely to be related to increased risk for these cancers. Worldwide, research continues to investigate this interesting group of cancers.
Yang PC, Davis S. Epidemiological characteristics of adenocarcinoma of the gastric cardia and distal stomach in the United States, 1973-1982. Int J Epidemiol 1988;17(2):293-297.
Blot WJ, Devesa SS, Kneller RW, Fraumeni JF Jr. Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA 1991;265:1287-1289.
Gammon MD, Schoenberg JB, Ahsan H, Risch HA, Vaughan TL, Chow WH, Rotterdam H, West AB, Dubrow R, Stanford JL, Mayne ST, Farrow DC, Niwa S, Blot WJ, Fraumeni JF Jr. Tobacco, alcohol, and socioeconomic status and adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst 1997;89(17):1277-1284.
Farrow DC, Vaughan TL, Hansten PD, Stanford JL, Risch HA, Gammon MD, Chow WH, Dubrow R, Ahsan H, Mayne ST, Schoenberg JB, West AB, Rotterdam H, Fraumeni JF Jr, Blot WJ. Use of aspirin and other nonsteroidal anti-inflammatory drugs and risk of esophageal and gastric cancer. Cancer Epidemiol Biomarkers Prev 1998;7(2):97-102.
Vaughan TL, Farrow DC, Hansten PD, Chow WH, Gammon MD, Risch HA, Stanford JL, Schoenberg JB, Mayne ST, Rotterdam H, Dubrow R, Ahsan H, West AB, Blot WJ, Fraumeni JF Jr. Risk of esophageal and gastric adenocarcinomas in relation to use of calcium channel blockers, asthma drugs, and other medications that promote gastroesophageal reflux. Cancer Epidemiol Biomarkers Prev 1998;7(9):749-756.
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