Barrett’s is an abnormal lining of the esophagus made of cells that are usually found elsewhere in the gut and it can predispose you to esophageal cancer. In the medical literature, many studies examine the association between cancer risk and Barrett’s esophagus. Studies demonstrate an annual risk of getting cancer at 0.2–2% or on average about 0.5% per year. Another way to look at this is if 200 people have Barrett’s esophagus, one person will get cancer each year. It is felt that the risk of getting esophageal cancer if you have Barrett’s is increased thirtyfold over people who do not have Barrett’s. Although when most people hear this they think they are going to die from cancer; fortunately uncommon things happen uncommonly.
Annually in the United States approximately 8,000 people get the cancer associated with Barrett’s esophagus called adenocarcinoma. Another kind of esophageal cancer is called squamous cell carcinoma. These cancers generally behave the same and unfortunately commonly can cause death. Under the microscope, they are different and can be treated differently. The risk factors for these two cancers are different as well. Squamous cell cancers are believed to be caused more by smoking and excessive alcohol use.
Now the good news: all cancer statistics have to be put in perspective. Esophageal cancer is rare even if you have Barrett’s esophagus. The American Cancer Society Web site reports that in 2004, 230,000 men had prostate cancer, 216,000 women had breast cancer, 174,000 people had lung cancer, and 150,000 people had colon cancer. Esophageal cancer does not even rank in the top eight types of cancer in the United States annually. When you look at it from a more global perspective, of the more than 1,350,000 new cancer diagnoses in 2004, only 14,000 cases were esophageal cancer, and half of those were associated with Barrett’s esophagus. Or consider it this way: of all the cancers in the United States in 2004, half of 1% (1 in 200 cancers) were associated with Barrett’s. When I give patients the diagnosis of Barrett’s esophagus, I tell them to relax. Even with Barrett’s, the risk of getting other cancers completely unrelated to the esophagus is much higher than is the risk of getting a cancer associated with Barrett’s. Doctors routinely screen for cancer, including prostate checks for men, mammograms, breast exams and pap smears for women, and colon cancer screening for those age 50 and older. For a patient with Barrett’s esophagus, periodic endoscopy and biopsies are added to the cancer screening routine, and the condition really is just another chronic medical problem.
The major issue with esophageal cancer is that generally it is a serious cancer that is usually found late and at an advanced stage. In 2004, 14,250 esophageal cancers were diagnosed; about half were adenocarcinoma. There were 13,300 deaths from esophageal cancer that year. More than 90% of people diagnosed with esophageal cancer die of it. (These data are available on the American Cancer Society Web site if you want more information.)
Barrett’s increases cancer risk because the repeated inflammation and injury with periodic healing damages the DNA of the abnormal esophageal lining. The DNA is the code within cells that regulates growth and cell division.When the DNA is damaged, it can result in cells with abnormal growth patterns that do not reproduce normally and that can evolve into cancer.
You may be able to decrease your cancer risk by avoiding smoking, limiting alcohol use, maintaining a healthy weight, eating a balanced diet that includes fruits and vegetables, taking heartburn medication, and getting periodic endoscopy if Barrett’s has developed. If you have questions, a lot of information is available, so ask your doctor.
By Mortin - Copyright 2009
Last modification 31/12/2009
What are the Odds of Getting Esophageal Cancer with Barrett’s Esophagus? - References