Published online Apr 15, 2024. doi: 10.4251/wjgo.v16.i4.1180
Peer-review started: December 19, 2023
First decision: December 27, 2023
Revised: January 9, 2024
Accepted: February 19, 2024
Article in press: February 19, 2024
Published online: April 15, 2024
Processing time: 113 Days and 14.8 Hours
Esophageal cancer ranks among the most prevalent malignant tumors globally, primarily due to its highly aggressive nature and poor survival rates. According to the 2020 global cancer statistics, there were approximately 604000 new cases of esophageal cancer, resulting in 544000 deaths. The 5-year survival rate hovers around a mere 15%-25%. Notably, distinct variations exist in the risk factors associated with the two primary histological types, influencing their worldwide incidence and distribution. Squamous cell carcinoma displays a high incidence in specific regions, such as certain areas in China, where it meets the cost-effectiveness criteria for widespread endoscopy-based early diagnosis within the local population. Conversely, adenocarcinoma (EAC) represents the most common histological subtype of esophageal cancer in Europe and the United States. The role of early diagnosis in cases of EAC originating from Barrett's esophagus (BE) remains a subject of controversy. The effectiveness of early detection for EAC, particularly those arising from BE, continues to be a debated topic. The variations in how early-stage esophageal carcinoma is treated in different regions are largely due to the differing rates of early-stage cancer diagnoses. In areas with higher incidences, such as China and Japan, early diagnosis is more common, which has led to the advancement of endoscopic methods as definitive treatments. These techniques have demonstrated remarkable efficacy with minimal complications while preserving esophageal functionality. Early screening, prompt diagnosis, and timely treatment are key strategies that can significantly lower both the occurrence and death rates associated with esophageal cancer.
Core Tip: Esophageal cancer, characterized by its aggressive nature and low survival rates, is one of the most common malignant tumors globally. Variations in risk factors between the two primary histological types, squamous cell carcinoma (ESCC) and adenocarcinoma (EAC), affect their incidence and distribution worldwide. While ESCC is prevalent in specific areas like China and meets criteria for cost-effective early diagnosis, EAC is predominant in Europe and the United States, with the role of early diagnosis in cases arising from Barrett's esophagus being a subject of controversy. The disparities in early-stage treatment across different regions are due to varying rates of early diagnosis, with countries like China and Japan advancing in endoscopic techniques for treatment. Early screening, diagnosis, and treatment significantly reduce the incidence and mortality of esophageal cancer.