Originally Posted by
Ray9
I understand your concern but there are many factors involved in the rise in this cancer not the least of which is chronic intake of alcohol coupled with decades of smoking. In fact alcohol is a major trigger of esophageal cancer. Your graph does not address the lifestyle choices of the afflicted. Alcohol suppresses the immune system.
No. Alcohol intake is related to squamous cell cancer of the esophagus, the incidence of which is declining. The increase in esophageal cancer is adenocarcinoma, which is directly related to Barrett's esophagus, which is directly related to reflux disease. Smoking is also related to adenocarcinoma, but of course the rate of smoking is declining. The two things that we see over the last 30 years that are increasing at the same rate as esophageal cancer are the increasing use of proton pump inhibitor medication for GERD treatment (Prilosec, for example), and increasing rates of obesity (which is directly related to GERD).
You're right that in some ways lifestyle choice plays a role in the rather amazing rate of increase in adenocarcinoma of the esophagus, but mainly as it relates to obesity. A body mass index greater than about 30 is about the point where reflux get increasingly problematic. For reference, about 1/3 of the US population is frankly obese (BMI > 30) and 2/3 is overweight or obese (BMI > 25). Those obesity rates have increased dramatically since about 1990, as has the incidence of GERD (and the incidence of adenocarcinoma of the esophagus).
As a lifestyle contributor to esophageal adenocarcinoma, the impact of alcohol and smoking pales in comparison to the contribution of obesity.
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