Smoking Cessation and Risk of Esophageal Cancer by Histological Type: Systematic Review and Meta-analysis

Wang, Qiaoli; Xie, Shao-Hua; Li, Wentao; Lagergren, Jesper

doi:10.1093/jnci/djx115

Cited by 61 publications

(54 citation statements)

References 80 publications

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“…31,32 Similarly, smokers were more likely to develop future oesophageal and proximal gastric cancers, consistent with previous literature. [33][34][35] Our findings regarding race and ethnicity are also similar to previously published studies. Those of Black, Asian, and Native Hawaiian/Pacific Islander were less likely to develop future oesophageal and proximal gastric cancers, as were those of Hispanic or Latino ethnicity, though this was not statistically significant.…”

Section: Con Clus Ionssupporting

confidence: 91%

Oesophageal and proximal gastric adenocarcinomas are rare after detection of Helicobacter pylori infection

Kumar

Metz

Ginsberg

et al. 2020

Aliment Pharmacol Ther

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Summary Background Helicobacter pylori infection is the most important risk factor for non‐proximal gastric adenocarcinoma, yet some posit it is protective against oesophageal adenocarcinoma and proximal gastric cancers. Aims To evaluate the incidence of and risk factors for future oesophageal and proximal gastric cancers, utilizing the largest North American cohort of patients with previously identified H pylori. Also to identify whether treatment and eradication of H pylori alter future oesophageal and proximal gastric cancer risk. Methods Retrospective cohort study within the Veterans Administration of 36 803 patients (median age 60.4 years; 91.8% male) with confirmed H pylori between 01 January 1994 and 31 December 2018. Primary outcome was diagnosis of future oesophageal and proximal gastric cancers. A time to event with competing risk analysis was performed, evaluating patient factors and whether the patient received H pylori treatment. Secondary analysis of those treated evaluated whether confirmed eradication was associated with cancer. Results The cumulative incidence of oesophageal and proximal gastric cancers 5, 10 and 15 years after H pylori detection was 0.145%, 0.26% and 0.34%. Risk of future oesophageal or proximal gastric cancer was similar amongst whites (reference), African Americans (SHR 0.87, 95%CI 0.57‐1.43) and American Indians (SHR 1.31, 95%CI 0.18‐9.60) but substantially reduced in those of Asian (no cases amongst 213 H pylori positive) or native Hawaiian origin (no cases amongst 295 H pylori positive) (P < .001). Increasing age (SHR 1.17 per 5 years, 95% CI: 1.09‐1.25, P < 0.001) and smoking (SHR 2.06, 95% CI: 1.33‐3.18, P = 0.001) were associated with oesophageal and proximal gastric cancers. Neither treatment of H pylori nor eradication status were associated with cancer (P > 0.20). Conclusions In the largest study of US patients with H pylori, we demonstrate that rates of oesophageal and proximal gastric cancers after treatment of H pylori are low. Older age, and smoking are associated with future cancer, whilst Asian or Native Hawaiian race are protective. H pylori treatment and eradication are not associated with future cancer.

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Section: Con Clus Ionssupporting

confidence: 91%

Oesophageal and proximal gastric adenocarcinomas are rare after detection of Helicobacter pylori infection

Kumar

Metz

Ginsberg

et al. 2020

Aliment Pharmacol Ther

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“…Compared to the strong link between tobacco use and the development of ESCC, the association between tobacco and EAC is only moderate (Table ). EAC risk in ever smokers was found to be twice as high as the risk in nonsmokers in a pooled analysis of several population‐based studies, and a recent meta‐analysis demonstrated a slight increase in relative risk from 1.60 to 2.34 in former smokers compared to current smokers . Currently, there is no evidence that alcohol consumption is a risk factor for EAC, even for individuals consuming seven or more drinks per day …”

Section: Esophageal Adenocarcinomamentioning

confidence: 99%

Screening high‐risk populations for esophageal and gastric cancer

Chung

Mullen

2019

Journal of Surgical Oncology

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Cancers of the esophagus and stomach remain important causes of mortality worldwide, in large part because they are most often diagnosed at advanced stages.Thus, it is imperative that we identify and treat these cancers in earlier stages. Due to significant heterogeneity in incidence and risk factors for these cancers, it has been challenging to develop standardized screening recommendations. This review summarizes the current recommendations for screening populations at high risk of developing esophagogastric cancers. K E Y W O R D SBarrett's esophagus, genetics, risk factors 1 | ESOPHAGEAL CANCER | IntroductionEsophageal cancer (EC) is one of the deadliest malignancies worldwide and is often diagnosed in its advanced stages. While EC is the 8th most common cancer in the world, it is the 6th most common cause of cancer-related deaths, with a 5-year survival rate of less than 20% despite advances in treatment. This poor prognosis is largely due to the often late detection of this cancer, owing primarily to the lack of early presenting symptoms. In the United States, stage IV is the most common stage at the time of diagnosis, 1 with greater than 30% of patients having metastatic disease at presentation. Certain countries around the world have addressed this with endoscopic screening programs for their high-risk populations, and with this many have seen a promising improvement in their survival rates.The screening of high-risk populations for EC differs for the two epidemiologically and biologically distinct subtypes of esophageal cancer. Esophageal adenocarcinoma (EAC) is the most common subtype in the United States, UK, and Western Europe and has been linked to gastroesophageal reflux disease (GERD) and obesity.Esophageal squamous cell carcinoma (ESCC) is the more common subtype worldwide, accounting for over 80% of EC cases. 2 ESCC is particularly prevalent in Asia, East Africa, and South America and is known to be associated with tobacco, alcohol, and consumption of nitrogenous foods. Rarely, other histological subtypes-sarcomas and small cell carcinomas-develop in the esophagus, comprising less than 1%-2% of all esophageal cancers. 3 Globally, the burden of disease is predominantly comprised of ESCC and EAC, and as distinct entities with both regional and epidemiologic differences, the methods and approaches to screening differ. 2 | ESOPHAGEAL ADENOCARCINOMA 2.1 | Epidemiology EAC is the predominant subtype of esophageal cancer in the United States, Europe, and Australia, with incidence rates that have risen by approximately 500% in the UK and 600% in the United States over the past four decades. Annual rates of increase range from 3.5% per year in Scotland to 8.1% per year in Hawaii, with a similar proportional increase in both men and women. 4 2.2 | Risk factors 2.2.1 | DemographicsThe risk of EAC is associated with older age, with the risk increasing by 3-to 4-fold in patients over the age of 50 years, 5 and male sex, with a 6-to 8-fold higher risk in males than females. 6 In the United States, the

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“…Several systematic reviews have strongly supported the association between exposure to smoked/smokeless tobacco and the insurgence of OSCC and ESCC . Ten years of smoking cessation‐period could diminish the risk of oral cancer to levels similar to that of a never‐smoker .…”

Section: Introductionmentioning

confidence: 99%

Autophagy modulators for the treatment of oral and esophageal squamous cell carcinomas

Khan

Relitti

Brindisi

et al. 2019

Medicinal Research Reviews

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Oral squamous cell carcinomas (OSCC) and esophageal squamous cell carcinomas (ESCC) exhibit a survival rate of less than 60% and 40%, respectively. Late-stage diagnosis and lack of effective treatment strategies make both OSCC and ESCC a significant health burden. Autophagy, a lysosome-dependent catabolic process, involves the degradation of intracellular components to maintain cell homeostasis. Targeting autophagy has been highlighted as a feasible therapeutic strategy with clinical utility in cancer treatment, although its associated regulatory mechanisms remain elusive. The detection of relevant biomarkers in biological fluids has been anticipated to facilitate early diagnosis and/or prognosis for these tumors. In this context, recent studies have indicated the presence of specific proteins and small RNAs, detectable in circulating plasma and serum, as biomarkers. Interestingly, the interplay between biomarkers (eg, exosomal microRNAs) and autophagic processes could be exploited in the quest for targeted and more effective therapies for OSCC and ESCC. In this review, we give an overview of the available biomarkers and innovative targeted therapeutic strategies, including the application of autophagy modulators in OSCC and ESCC.Additionally, we provide a viewpoint on the state of the art Tuhina Khan and Nicola Relitti contributed equally to this work. and on future therapeutic perspectives combining the early detection of relevant biomarkers with drug discovery for the treatment of OSCC and ESCC. K E Y W O R D S autophagy, autophagy modulators, biomarkers, esophageal squamous cell carcinoma, exosomes, oral squamous cell carcinoma, targeted therapy 1 | INTRODUCTION Oral squamous cell carcinoma (OSCC) is the predominant malignant neoplasm of the oral cavity followed by verrucous carcinoma, undifferentiated carcinoma, and small salivary adenocarcinoma. 1 Esophageal squamous cell carcinoma (ESCC) is the first histological type and accounts for 80% of cases of esophageal cancer. 2 OSCC and ESCC are indicated as one of the most common cancers by the International Union Against Cancer with an annual incidence of 275 000 and 456 000 cases worldwide, respectively. 3,4 The primary etiology in both OSCC and ESCC is attributed to the environmental factors (tobacco abuse, alcohol consumption), genetic factors (eg, mutations in enzymes), viral factors (human papilloma virus [HPV] infection), and/or the coexistence of these factors. Alcohol intake and tobacco use are responsible for at least 75% of these carcinomas. The underlying initiation and progression mechanisms of OSCC and ESCC are generally characterized by the accumulation of serial epigenetic and genetic alterations, which eventually lead to uncontrolled proliferation of the mutated cells, followed by vigorous cell division. 5,7 Early-stage OSCC detection displays an 80% survival rate at 5 years, while detection at advanced stage leads to survival rates ranging from 20% to 40%. 6 In ESCC, the 5-year survival rate for early-stage detection may reach 85%, whereas a dr...

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Smoking Cessation and Risk of Esophageal Cancer by Histological Type: Systematic Review and Meta-analysis

Abstract: Abbreviations used in this paper: CI, confidence intervals; RR, risk ratio; ESCC, esophageal squamous cell carcinoma; EAC, esophageal adenocarcinoma. 2 ABSTRACTBackground: Tobacco smoking strongly increases risk of esophageal squamous cell carcinoma

Cited by 61 publications

References 80 publications

Oesophageal and proximal gastric adenocarcinomas are rare after detection of Helicobacter pylori infection

Oesophageal and proximal gastric adenocarcinomas are rare after detection of Helicobacter pylori infection

Screening high‐risk populations for esophageal and gastric cancer

Autophagy modulators for the treatment of oral and esophageal squamous cell carcinomas

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