A Snapshot of Esophageal Cancer

Incidence and Mortality

Esophageal cancer consists of two primary types, adenocarcinoma and squamous cell carcinoma. Of these two types, adenocarcinoma of the esophagus is more common than squamous cell carcinoma in the United States due to its rising incidence, particularly in white men. Regardless of race or ethnicity, men have higher incidence and mortality rates than do women. Historically, esophageal cancer mortality rates for African-American men have been higher than those for white men, although a steady decline over the past two decades coupled with increasing rates in whites has recently reversed this trend. The downward trend in mortality has not been observed for other racial/ethnic groups.

Risk factors for esophageal cancer include tobacco use, heavy alcohol use, Barrett esophagus, gastric reflux, increasing age, and being male. There is no standard or routine screening test for esophageal cancer. Standard treatment options for esophageal cancer include surgery, radiation therapy, chemotherapy, laser therapy, and electrocoagulation.

It is estimated that approximately $1.3 billion¹ is spent in the United States each year on esophageal cancer treatment.

Trends in NCI Funding for Esophageal Cancer Research

The National Cancer Institute's (NCI) investment² in esophageal cancer research increased from $22.3 million in fiscal year (FY) 2007 to $33.0 million in FY 2011. In addition to this funding, NCI supported $6.0 million in esophageal cancer research in FY 2009 and 2010 using funding from the American Recovery and Reinvestment Act (ARRA).³

Examples of NCI Activities Relevant to Esophageal Cancer

• The Chemopreventive Agent Development Research Group provides scientific and administrative oversight for chemoprevention agent development from preclinical research to early phase I clinical trials. The program is currently supporting research on several agents for potential chemoprevention of esophageal cancer.
• The Epidemiology of Esophageal Cancer Consortia include the Asian Barrett's Consortium and the International Barrett's and Esophageal Adenocarcinoma Consortium (BEACON), which were formed to enhance international collaborations in research into the etiology and prevention of Barrett esophagus and esophageal adenocarcinoma.
• NCI supports early-phase clinical trials of targeted, personalized cancer regimens through the Accelerating Clinical Trials of Novel Oncologic PathWays (ACTNOW) program, including a phase II trial in patients with advanced gastric and gastroesophageal junction carcinoma.
• The Phase III Randomized Study of Radiotherapy, Paclitaxel, and Carboplatin with versus without Trastuzumab in Patients with HER2-Overexpressing Esophageal Adenocarcinoma is investigating whether adding targeted therapy to chemotherapy and radiation will reduce disease recurrence and extend survival in people with HER2-positive esophageal cancer.
• The Esophagus Cancer Modeling project, conducted by the Cancer Intervention and Surveillance Modeling Network (CISNET), explores the incidence and mortality of esophageal adenocarcinoma, hypothetical screening strategies, chemotherapy, and endoscopic therapy.
• Seven gastrointestinal-cancer-specific Specialized Programs of Research Excellence (SPOREs) focus on translational research on the gastrointestinal system, including esophageal cancer.

Selected Advances in Esophageal Cancer Research

• A genomic analysis found that inherited mutations in three genes were associated with increased risk of Barrett esophagus and esophageal adenocarcinoma. Published July 2011. [PubMed Abstract]
• A transgenic mouse model was developed that provides new insights into the molecular and cellular origins of Barrett esophagus and esophageal adenocarcinoma. Published January 2012. [PubMed Abstract]
• Researchers identified two new microRNA markers associated with progression of Barrett esophagus to esophageal adenocarcinoma. Published February 2012. [PubMed Abstract]
• Researchers discovered that two signaling pathways interact during development of esophageal adenocarcinoma, suggesting that patients might benefit from a two-pronged therapy approach. Published March 2012. [PubMed Abstract]
• See this PubMed list of selected free full-text journal articles on NCI-supported research relevant to esophageal cancer. You can also search PubMed for additional scientific articles.

• ¹ Cancer Trends Progress Report, in 2010 dollars.
• ² The estimated NCI investment is based on funding associated with a broad range of peer-reviewed scientific activities. For additional information on research planning and budgeting at the National Institutes of Health (NIH), see About NIH.
• ³ For more information regarding ARRA funding at NCI, see Recovery Act Funding at NCI.
• ⁴ Scientific Area Codes
• ⁵ NCI Funded Research Portfolio