Welcome to ESOCAN

An educational resource dedicated to the
prevention and control of esophageal cancer.

Each year over one half million people in the world are diagnosed with esophageal cancer. Unfortunately most do not survive more than a year, making it the sixth most common cause of cancer-related death. Much is known about the risk and protective factors for this cancer, providing opportunities for prevention through avoiding causative exposures, engaging in healthy activities, chemoprevention and in some cases, screening for precancerous conditions.

The purpose of this site is to promote awareness of esophageal cancer, summarize it's epidemiology (see background and risk and preventive factors) and demonstrate how this information can be used for personalized cancer prevention. See Learn More below and menu tab. Additional information resources can be found in a menu tab as well.

Most esophageal cancers worldwide are classified as squamous cell type. In the early 1970s, however, a previously unusual histologic type - adenocarcinoma - began a rapid rise in incidence that continued for over four decades to become the dominant type of esophageal cancer in the West. The BEACON consortium tab summarizes findings from this epidemiologic research consortium which was founded in 2005 to study underlying reasons for the increase and identify potential preventive measures.

‍New research findings relevant to esophageal cancer causes and prevention will be highlighted from time to time in the blog. If you would like updates delivered to your inbox (1 - 2 per month), sign up for the newsletter.

Pie chart of cancer-related mortality
Esophageal cancer is the sixth most frequent cause of cancer-related death in the world.
[Global cancer statistics 2018: CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 ACS]

Learn more

Diagram of esophagus

Background

describes the basic epidemiology of esophageal cancer

Diagram of risk factors and pathways

Risk Factors

summarizes what is known about possible causes of esophageal cancer and opportunities for prevention

Screenshot of risk calculator

What's Your Risk?

introduces the IC-RISC™risk calculator which estimates an individual’s risk of developing esophageal adenenocarcinoma

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Recent News:

Clinical trial on RFA in low grade dysplasia
Results from this clinical trial on RFA vs. annual surveillance in persons with low grade dysplasia were modestly supportive of RFA in this population, with a 62% reduction in prevalence of Barrett's after three years which was of borderline statistically significance. One or more adverse events were experience by 19% of the RFA group, while spontaneous regression of LGD was observed in almost 1/3 of the surveillance patients. The small size of the study is an important limitation which limits interpretation.
Three-tiered screening program proposed
Drs. Yusuf and Fitzgerald review recent technological advancements in screening for Barrett's esophagus and propose a three-tier approach using risk prediction algorithms and minimally invasive approaches to improving detection rate for Barrett's and EAC
Review of Barrett's and Esophageal Adenocarcinoma
The authors review the incidence of BE and EAC and associated risk factors, evidence for improved outcomes among patients with a prior diagnosis of BE compared to those without, discuss the challenges of developing sufficiently accurate prediction models in the context of high population prevalence of risk factors (e.g., obesity, reflux, smoking), and emphasize the need for larger biomarker studies.
Good news in treatment of esophageal cancer
Dr. Ilson's editorial in the New England Journal of Medicine puts new findings regarding the monoclonal antibody, nivolumab, in treatment of esophagal cancer in perspective. [Figure from original research article by Kelly, et al in same issue]
Review of world-wide GI cancer epidemiology
The authors extensively review the epidemiology (incidence, risk factors, prevention) of cancers of the colon, stomach and esophagus across China, the US and Europe
Dutch study on RFA/EMR effectiveness
In an observational study of 1154 patients with BE or early EAC, 94% achieved complete eradication after treatment with RFA/EMR. A dysplasia recurrence rate of 1% per year was observed over a median 43 months.
About
This website contains a curated and opinionated look at recent literature regarding the epidemiology and prevention of esophageal cancer, with an emphasis on esophageal adenocarcinoma. It is developed by Thomas L Vaughan MD, MPH, who can be reached with questions or suggestions through email or his research website.
©2021 Thomas L Vaughan
Disclaimer
This website should not be considered, or used as a substitute for, medical advice, diagnosis or treatment. This site does not constitute the practice of any medical or other professional health care advice, diagnosis or treatment. The information on this website represent the views solely of Dr. Vaughan.
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