A Snapshot of Esophageal Cancer

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Incidence and Mortality

Esophageal cancer consists of two primary cancer types, esophageal adenocarcinoma and esophageal squamous cell carcinoma. Esophageal adenocarcinoma is more common in the United States. Men of all racial and ethnic groups have higher esophageal cancer incidence and mortality rates than women. Historically, African American men have had higher esophageal cancer incidence and mortality rates than white men; however, increasing incidence and mortality rates in white men and a steady decline among African American men in the past decade have reversed this trend. A downward trend in mortality has not been observed for any other racial/ethnic group.

Risk factors for esophageal cancer include tobacco use, alcohol use, having Barrett's esophagus or gastric reflux disease, and increasing age. Common signs of esophageal cancer include painful or difficult swallowing and unexplained weight loss. There are no standard or routine screening tests for esophageal cancer. Tests and procedures that are used to detect and diagnose esophageal cancer include a physical examination, upper endoscopy, chest x-ray, and a barium swallow test. Standard treatment options for esophageal cancer include surgery, radiation therapy, chemotherapy, chemoradiation therapy, laser therapy, and electrocoagulation.

Assuming that incidence and survival rates follow recent trends, it is estimated that $1.6 billion1 will be spent on esophageal cancer care in the United States in 2014.

Line graphs showing U.S. Esophageal Cancer Incidence and mortality per 100,000, by race and gender.  Incidence from 1991-2011 and mortality from 1990-2010 is shown. In 2011, white males have the highest incidence, followed by African American males, African American females, and white females. In 2010, white males have the highest mortality, followed by African-American males, African American females, and white females.

Source: Surveillance, Epidemiology, and End Results (SEER) Program and the National Center for Health Statistics. Additional statistics and charts are available at the SEER Web site.

NCI’s Investment in Esophageal Cancer Research

To learn more about the research NCI conducts and supports in esophageal cancer, visit the NCI Funded Research Portfolio (NFRP). The NFRP includes information about research grants, contract awards, and intramural research projects funded by NCI. When exploring this information, it should be noted that approximately half of the NCI budget supports basic research that may not be specific to one type of cancer. By its nature, basic research cuts across many disease areas, contributing to our knowledge of the underlying biology of cancer and enabling the research community to make advances against many cancer types. For these reasons, the funding levels reported in NFRP may not definitively report all research relevant to a given category.

Pie chart of NCI Esophageal Cancer Research Portfolio.  Percentage of total dollars by scientific area.  Fiscal year 2013.  Biology, 16%.  Etiology/causes of cancer, 9%.  Prevention, 8%.  Early detection, diagnosis, and prognosis, 32%[CS1] .  Treatment, 22%.  Cancer control, survivorship, and outcomes research, 10%.  Scientific model systems, 3%.

Source: NCI Funded Research Portfolio. Only projects with assigned common scientific outline area codes are included. A description of relevant research projects can be found on the NCI Funded Research Portfolio Web site.

Other NCI programs and activities relevant to esophageal cancer include:

Selected Advances in Esophageal Cancer Research

  • A genome-wide association study of esophageal adenocarcinoma and Barrett's esophagus identified three new susceptibility loci for their development. Published October 2013. [PubMed Abstract]
  • HER2 protein expression and gene amplification are highly concordant in patients with esophageal adenocarcinoma. HER2 expression was also positively associated the expression of its partner, HER3, in esophageal adenocarcinoma supporting ongoing therapeutic efforts to target this interaction. Published October 2013. [PubMed Abstract]
  • In a retrospective case-control study, statin use was associated with a reduced risk of Barrett's esophagus, especially in obese patients. Published May 2014. [PubMed Abstract]
  • A comprehensive genomic comparison of two potential precursor tissues for esophageal adenocarcinoma—intestinal metaplasia (IM) and nongoblet cell metaplasia— (NGM), showed that IM has a much higher frequency of cancer-associated mutations than NGM. Published July 2014. [PubMed Abstract]

Additional Resources for Esophageal Cancer

What You Need To Know About™ Cancer of the Esophagus
Describes treatment options, types of cancer doctors, second opinion, follow-up care, and sources of support for someone recently diagnosed with esophageal cancer.

Esophageal Cancer Home Page
NCI's gateway for information about esophageal cancer.

Esophageal Cancer Treatment (PDQ®)
Expert-reviewed information summary about the treatment of esophageal cancer.

Clinical Trials for Esophageal Cancer

  • Posted: November 5, 2014