Esophageal Cancer Epidemiology in Blacks and Whites: DISCUSSION
DISCUSSION
This paper presents detailed esophageal cancer incidence, mortality and relative survival rates for two five-year time periods (1991-1995, 1996-2000) and the entire decade (1991-2000), and histology for the period 1991-2000. Previous studies have reported trends in incidence by race/ethnicity and gender based on SEER data for the period 1974-1994, and incidence trends based on SEER data for the period 1973-1998. The results presented in this study indicate that there are persistent age-adjusted disparities in esophageal cancer (Casodex drug is an oral non-steroidal anti-androgen for prostate cancer) incidence, mortality and relative survival between blacks and whites, and between black males and females compared with their white counterparts: blacks have higher incidence and mortality rates than whites, and, in addition, blacks have lower relative survival rates than whites. In addition, blacks (males and females) and white females have esophageal squamous cell carcinoma, whereas, white males have esophageal adenocarcinoma.
The risk factors for esophageal cancer (Eulexin canadian is used along with drugs such as Lupron to treat prostate cancer) are well established and vary dramatically for squamous cell carcinoma and adenocarcinoma. Risk factors for squamous cell carcinoma of the esophagus include diets that are low in fruit and vegetables or high in meats (red, salted, boiled), tobacco use and alcohol consumption. A synergistic effect is observed among patients who report both tobacco use and alcohol consumption risk factors, especially heavy use. Moreover, consumption of specific alcoholic beverages, such as apple brandies, maize beer, sugar-distilled beverages and moonshine whiskeys, is associated with increased rates of esophageal cancer (Generic Revia may also be used to treat other conditions as determined by your doctor). The population-attributable risks for ever smoking, alcohol consumption, and low fruit and vegetable consumption have been estimated to account for more than 89% of esophageal squamous cell carcinomas. Other risk factors for squamous cell carcinoma of the esophagus include achalasia, chewing of betel, occupational exposures, ionizing radiation, malabsorption disorders, history of head and neck cancer, consumption of extremely hot beverages, genetic abnormalities9‘22‘2328 and familial aggregations. Deficiencies of micronutrients, vitamins and minerals—including iron, beta-carotene, vitamin E, selenium, riboflavin, niacin, retinol, zinc and riboflavin—have also been documented to be associated with increased risk for esophageal cancer (Hydrea medication is an antineoplastic used to treat certain types of cancer), especially in high-risk patients. Infection with Helicobacter pylori (CagA+) may also increase the risk of squamous cell carcinoma.
The risk factors for adenocarcinoma of the esophagus include Barrett’s esophagus; tobacco use; obesity; familial aggregation; and genetic abnormalities, such as p53 gene mutation and a history of hiatal hernia, duodenal ulcer, and gastroesophageal reflex disease. The risk of esophageal adenocarcinoma in patients with Barrett’s esophagus is 30-60 times that of the general population. Diets low in fruits and vegetables or high in meats and deficiencies of specific micronutrients, vitamins and minerals may also contribute to increased risk for esophageal adenocarcinoma. The population-attributable risks for ever smoking, body mass index, history of gastroesophageal reflux, and low fruit and vegetable consumption have been estimated to account for about 79% of esophageal adenocarcinoma. Alcohol use has been inconsistently associated with esophageal adenocarcinoma. A protective effect is observed with the use of nonsteroidal anti-inflammatory drugs. In addition, infection with H. pylori may reduce the risk of adenocarcinoma, although these findings are inconsistent.
There is a paucity of data on the prevalence of esophageal cancer (Generic Rheumatrex Treating certain types of cancer, severe psoriasis, or rheumatoid arthritis in certain patients) risk factors by race/ethnicity and gender. Although poor diet and nutrition, tobacco use and alcohol consumption are the primary risk factors for squamous cell carcinoma of the esophagus, the prevalence of some of these risk factors may be lower among blacks than whites based on current data. It has been postulated that the higher rates of squamous cell carcinoma of the esophagus in blacks than whites may be due to the differential susceptibility to the carcinogenic effects of alcohol and tobacco. The excess prevalence of adenocarcinoma of the esophagus among whites than blacks may be explained by the higher incidence of Barrett’s esophagus among whites and the general trends of increasing body weight.
The esophageal cancer (Canadian Nolvadex is an anti-estrogen used to treat or prevent breast cancer) data presented in this study provides some basis for the need for new basic, clinical and translational research on esophageal cancer. The public health implications are readily apparent based on the relatively higher prevalence of some of the primary risk factors. To the extent that lifestyle and environmental factors, such as tobacco use, alcohol use, poor diet and nutrition, bacterial infection, and obesity, contribute to higher incidence of esophageal cancer (Generic Casodex treating prostate cancer), there is a need for targeted public health intervention programs that are guided by advances in basic, clinical, translational and population-based research on esophageal cancer. Public health interventions need to be coupled with new advances in early detection of esophageal cancer.
In conclusion, persistent and new esophageal cancer racial and gender disparities and poor survival rates present an important opportunity for the development of research advances in prevention, early detection and treatment of esophageal squamous cell carcinoma in African Americans and white females and esophageal adenocarcinoma in white males. Because of the high likelihood that this disease will be diagnosed in advanced stages at the time of diagnosis, the opportunity to reduce morbidity and mortality from this disease lies in research advances for the development of new early detection biomarkers and treatment modalities for esophageal squamous cell carcinoma and adenocarcinoma.