Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2015; 21(26): 7933-7943
Published online Jul 14, 2015. doi: 10.3748/wjg.v21.i26.7933
Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries
María José Domper Arnal, Ángel Ferrández Arenas, Ángel Lanas Arbeloa
María José Domper Arnal, Ángel Ferrández Arenas, Department of Gastroenterology, University Hospital LB, Aragon Health Research Institute, IIS Aragon, 50009 Zaragoza, Spain
Ángel Lanas Arbeloa, Department of Gastroenterology, University Hospital LB, Aragon Health Research Institute (IIS Aragón) Vice-Dean for Research Affaires, University of Zaragoza School of Medicine CIBERehd, 50009 Zaragoza, Spain
Author contributions: Domper Arnal MJ provided the conception and design of the study, acquisition of data, and analysis and interpretation of data; Ferrández Arenas Á analysis and interpretation of data, drafting the article and making critical revisions related to important intellectual content of the manuscript; Lanas Arbeloa Á drafting the article and making critical revisions related to important intellectual content of the manuscript; approval of the version of the article to be published.
Conflict-of-interest statement: This research group presents no conflict of interest in this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. María José Domper Arnal, Department of Gastroenterology, University Hospital LB, Aragon Health Research Institute, IIS Aragon, Avda. San Juan Bosco 15, 50009 Zaragoza, Spain. mariajoseda_7@hotmail.com
Telephone: +34-976-765700 Fax: +34-976-768846
Received: January 10, 2015
Peer-review started: January 10, 2015
First decision: February 10, 2015
Revised: March 11, 2015
Accepted: April 16, 2015
Article in press: April 17, 2015
Published online: July 14, 2015
Processing time: 185 Days and 7.4 Hours
Abstract

Esophageal cancer is one of the most unknown and deadliest cancers worldwide, mainly because of its extremely aggressive nature and poor survival rate. Esophageal cancer is the 6th leading cause of death from cancer and the 8th most common cancer in the world. The 5-year survival is around 15%-25%. There are clear differences between the risk factors of both histological types that affect their incidence and distribution worldwide. There are areas of high incidence of squamous cell carcinoma (some areas in China) that meet the requirements for cost-effectiveness of endoscopy for early diagnosis in the general population of those areas. In Europe and United States the predominant histologic subtype is adenocarcinoma. The role of early diagnosis of adenocarcinoma in Barrett’s esophagus remains controversial. The differences in the therapeutic management of early esophageal carcinoma (high-grade dysplasia, T1a, T1b, N0) between different parts of the world may be explained by the number of cancers diagnosed at an early stage. In areas where the incidence is high (China and Japan among others) early diagnoses is more frequent and has led to the development of endoscopic techniques for definitive treatment that achieve very effective results with a minimum number of complications and preserving the functionality of the esophagus.

Keywords: Oesophageal cancer; Adenocarcinoma; Squamous cell carcinoma; Epidemiology; Barrett’s oesophagus; Screening; Early stage; Endoscopic mucosal resection; Endoscopic submucosal disection

Core tip: Esophageal cancer is a disease with a non-negligible impact, being the 6th leading cause of death from cancer, and with a very high morbidity and mortality due to diagnosed in advanced stages. A better understanding of the epidemiology, the natural history, and the risk factors could lead to an earlier diagnosis and treatment by endoscopic methods or by other less aggressive techniques. As a result, we could improve treatment outcomes, even though less aggressive modalities. This article provides a global perspective by comparing the management of esophageal cancer in Western and Eastern countries with particular emphasis on current prevention strategies.