UK rates of oesophageal cancer among worst in Europe
Publication Date:16/07/2008
Cancer of the oesophagus is on the increase in the UK, with rates much higher than in the rest of Europe.
That’s the message from the chief medical officer for England, who published a report on the subject this week. We take a look at the possible causes for this worrying trend.
What do we know already?
The oesophagus is the tube that carries food from your mouth to your stomach. It’s also known as the gullet. There are two types of cancer of the oesophagus. One is called squamous cell oesophageal cancer. It’s linked to smoking and drinking a lot of alcohol. The other is adenocarcinoma. It’s linked to smoking, obesity (being very overweight) and a condition called acid reflux.
Acid reflux is where stomach acid escapes from your stomach into your oesophagus. It can cause heartburn and give you a nasty taste in your mouth. Usually, it doesn’t cause any major problems, except discomfort. But in about 1 in 10 people who get it regularly, the acid damages the oesophagus (a condition called Barratt’s oesophagus). Over time, this damage may lead to cancer. However, this only happens to 1 in 200 people with Barratt’s oesophagus. So your overall chance of getting oesophageal cancer from acid reflux is quite low.
Acid reflux can be caused by a weak muscle at the bottom of the oesophagus, where it meets the stomach. It’s more common among people who are very overweight (obese).
There are treatments for cancer of the oesophagus, but it’s a difficult cancer to treat. Not many people survive for five years after being diagnosed with this type of cancer.
What does the new report say?
In most parts of Europe, rates of cancer of the oesophagus are going down. But in the UK, they’re going up. Rates among women are the highest in Europe, and rates for both men and women are much higher than the average across the European Union.
On average across Europe, 9 in every 100,000 men and 2 in every 100,000 women get oesophageal cancer during their lifetime. But in England, on average, 14 in every 100,000 men and 6 in every 100,000 women get oesophageal cancer.
The rates of adenocarcinoma are going up faster than the rates of squamous cell oesophageal cancer.
We don't know why rates of this cancer are rising in the UK. That’s alarming, because it's hard to tackle a problem unless you know the cause. But there are some possibilities:
- More people are very overweight or obese in the UK than they used to be. This means they are more likely to get acid reflux, which can damage the oesophagus.
- Some commonly-prescribed heart drugs (called nitrates) may cause acid reflux for some people. It's possible that more people are being prescribed these drugs.
- A common infection (called Helicobacter pylori) that can cause stomach ulcers reduces the amount of acid in the stomach. But treatment to get rid of the infection means the amount of acid in the stomach goes back to normal. If more people are treated for Helicobacter pylori, they may be more likely to get acid reflux.
No one is suggesting that people should stop taking heart drugs, or not get treated for stomach ulcers. We don't know yet if these treatments really play a part in the rise in cases of oesophageal cancer. They are just some of the things that need to be investigated by researchers.
Where does the report come from?
The report comes from the chief medical officer for England, Sir Liam Donaldson. He is the government's chief advisor on medical matters. The report is published by the Department of Health.
What does this mean for me?
It's important for everyone to know the symptoms of oesophageal cancer. These are:
- Stomach pain
- Difficulty swallowing
- Losing weight without trying to.
Anyone who gets these symptoms should see a doctor. Lots of things could be causing the symptoms, but it's important to get them checked out.
What should I do now?
There are a number of things you can do to lower your risk of getting oesophageal cancer.
- Don't smoke.
- Eat a healthy diet, with plenty of fruit, vegetables and fibre.
- Drink sensible amounts of alcohol, within the recommended limits.
- Keep at a healthy weight.
If you get heartburn often (twice a week or more), see a doctor. There are treatments that can help reduce your symptoms and possibly help the oesophagus to heal. But we don't know if these treatments reduce your chance of getting oesophageal cancer.
From:
Department of Health. On the state of public health: annual report of the chief medical officer 2007. Available at http://www.dh.gov.uk/cmo.
To find out more about acid reflux, see our information on heartburn.
News Archive
© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
