Esophageal Cancer in Young People: A Case Series of 109 Cases and Review of the Literature

Abstract

Certain geographically distinct areas of the world have very high rates of esophageal cancer (EC). Previous studies have identified western Kenya as a high risk area for EC with an unusual percentage of cases in subjects 30 years of age or younger. To better understand EC in these young patients, we abstracted available data on all 109 young patients diagnosed with EC at Tenwek Hospital, Bomet District, Kenya from January 1996 through June 2009, including age at diagnosis, sex, ethnicity, tumor histology, residence location, and medical interventions. We also attempted to contact all patients or a family member and obtained information on ethnicity, tobacco and alcohol use, family history of cancer, and survival. Sixty (55%) representatives of the 109 young patients were successfully interviewed. The median survival time of these 60 patients was 6.4 months, the most common tumor histology was esophageal squamous cell carcinoma (ESCC) (98%), the M:F ratio was 1.4∶1, and only a few subjects used tobacco (15%) or alcohol (15%). Seventy-nine percent reported a family history of cancer and 43% reported having a family history of EC. In summary, this case series describes the largest number of young EC patients reported to date, and it highlights the uniqueness of the EC experience in western Kenya.

Clinical and epidemiologic variations of esophageal cancer in Tanzania

“…This can be observed for all age groups and sexes. This is an interesting observation, as the Western part of Kenya has been noted to have a higher incidence compared to other areas in Kenya [6,[10][11][12][13][14] . Because our study hospital (ORCI) is on the eastern side of Tanzania, the higher rates of the disease from eastern Tanzania might be related to more accessibility to care.…”

“…There is also a large variation of risk for EC based on geographic region in Africa. Specifically, West Kenya and the Rift Valley Province of Kenya have shown high rates [6,[11][12][13][14][15] . These regional differences may reflect risk and etiologic factors other than tobacco and alcohol [6,11] .…”

“…Specifically, West Kenya and the Rift Valley Province of Kenya have shown high rates [6,[11][12][13][14][15] . These regional differences may reflect risk and etiologic factors other than tobacco and alcohol [6,11] . Tanzania, located on the southern border of Kenya, is one of the poorest countries in the world, and a location where EC is commonly found [6] .…”

A Study To Determine Relation Between Chronic Tobacco Ingestion And Gastro-Intestinal Lesions In Western Uttar Pradesh : An Endoscopic Study.

“…Numerous studies and research articles have now proven that while adenocarcinoma is on the rise in western countries, in developing countries such as India, it is squamous cell carcinoma which has a higher incidence and prevalence thereby causing a higher mortality. 9 No significant difference in gender was noted for the occurrence of gastrointestinal malignancy,though. Dar NA, Bhatt GA et Al.…”

Resistance to Cetuximab in EGFR-Overexpressing Esophageal Squamous Cell Carcinoma Xenografts Due to FGFR2 Amplification and Overexpression

“…Despite extensive investigations of therapeutic improvements in surgical techniques, carcinoma of the esophagus remains a devastating disease and one of the most frequent causes of cancer-related deaths in the world (1,2). The vast majority of esophageal cancers occur as either squamous cell carcinoma in the middle or upper third of the esophagus (ESCC) or as adenocarcinoma in the distal third or esophagogastric junction, with other tumor types occurring only very rarely.…”