CARCINOMA OF THE OESOPHAGUS Epidemiology

CARCINOMA OF THE OESOPHAGUS Epidemiology

Oesophageal cancer is the eighth most common cancer worldwide and the sixth most common cause of cancer death. It most commonly presents in the sixth and seventh decades of life. Squamous cell carcinoma and adenocarcinoma are the most common cell types while other malignancies such as melanoma and small cell carcinomas are rare. Secondary malignancies are likewise rare; however, bronchogenic carcinoma or metastatic lymph nodes can invade the oesophagus. Squamous cell cancer is the predominant histological cell type but there are significant geographical and ethnic varia tions, with the incidence of oesophageal cancer 50–100-fold the world. higher in areas of high incidence than in the rest of Squamous cell carcinoma incidence r emains steady; however, among white populations, especially in developed Western countries, there has been an epidemiological shift since the 1990s from squamous cell carcinoma to adenocarcinoma such that the incidence of adenocarcinoma has surpassed that of squamous cell cancer.

(a) Mucosal incision (b) Submucosal tunnelling Figure 66.43 Submucosal tunnelling endoscopic resection (STER) technique to excise a leiomyoma. (b) Endoscopic ultrasound /f_i nding