Can you get esophageal cancer at a young age

This is in part explained by the fact that people who are obese are more likely to have gastroesophageal reflux. Certain substances in the diet may increase esophageal cancer risk. For example, there have been suggestions, as yet not well proven, that a diet high in processed meat may increase the chance of developing esophageal cancer. This may help explain the high rate of this cancer in certain parts of the world.

On the other hand, a diet high in fruits and vegetables probably lowers the risk of esophageal cancer. The exact reasons for this are not clear, but fruits and vegetables have a number of vitamins and minerals that may help prevent cancer.

This might be the result of long-term damage to the cells lining the esophagus from the hot liquids. People who engage in regular physical activity may have a lower risk of adenocarcinoma of the esophagus. In this condition, the muscle at the lower end of the esophagus the lower esophageal sphincter does not relax properly.

Food and liquid that are swallowed have trouble passing into the stomach and tend to collect in the lower esophagus, which becomes stretched out dilated over time. The cells lining the esophagus in that area can become irritated from being exposed to foods for longer than normal amounts of time. People with achalasia have a risk of esophageal cancer that is many times normal. On average, the cancers are found about 15 to 20 years after the achalasia began. This is a rare, inherited disease that causes extra growth of the top layer of skin on the palms of the hands and soles of the feet.

People with this condition also develop small growths papillomas in the esophagus and have a very high risk of getting squamous cell cancer of the esophagus. People with tylosis need to be watched closely to try to find esophageal cancer early. This included 65 males and 44 females, a M:F ratio of 1. Eighty percent of the young patients were of the Kalenjin ethnic group. Figure 1 is a map showing the residence locations of all of the patients.

In the subgroup with follow-up information Table 2 , the M:F ratio was 1. We examined several known risk factors for EC in the 60 followed patients Table 3. A search of the literature found 37 articles describing cases of EC patients 30 years of age or younger.

Of the 43 cases with reported ages, the median age was 17 years and the age range was from 8 years to 30 years. The M:F ratio in the reported cases was 1. The M:F ratio was 1. This high percentage has not been reported anywhere else in the world. Among the total cases and the 60 cases with follow-up information, the M:F ratio was close to 1.

This is similar to the gender distribution of cases found in all EC patients seen at Tenwek 1. This M:F ratio is much lower than those found in industrialized countries [13]. This large percentage of ESCC may even be an underestimate, because some of the small number of EAC cases identified at Tenwek Hospital may have originated in the gastric cardia. Two primary risk factors for esophageal cancer in Western populations are smoking tobacco and drinking alcoholic beverages in excess [15].

We found that tobacco and alcohol consumption were reported by only a minority of young EC cases at Tenwek, which supports the argument that although these exposures are associated with EC in developed countries, they do not seem to be major etiologic factors in this area.

The contribution of other risk factors will require formal etiologic studies, but may include consumption of very hot tea [19] , limited diet [20] , exposure to polycyclic aromatic hydrocarbons [21] , or genetics. It is also important to note that most young patients in this series were of Kalenjin ethnicity, although the meaning of this is difficult to assess in a case-series. A similar proportion of Kalenjins has been reported among EC patients from the traditional catchment area around Tenwek Hospital [7].

The high proportion of cases with a family history of EC and the apparent restriction to a specific ethnic background both suggest that genetic factors could be important in the etiology of EC in this area, but these observations could also reflect shared environmental risk factors such as socioeconomic status, diet, use of similar traditional medicines [22] or foods, or communicable diseases.

Of the followed patients, survival was poor, with a median of 6. In all populations, the majority of EC cases are diagnosed at an advanced stage, and it appears that this is especially true among young patients at Tenwek. Local knowledge of the high case fatality rate may further discourage cases from coming to the hospital until the cancer is very advanced. Our literature review shows that little is known about EC in young people in any population. We found several case series of young patients from India, but only limited reports from other countries.

These literature reports also suggest that the demographic and tumor characteristics of EC in young patients are similar to those of EC in older patients from the same populations: the M:F ratio in the reported young patients was close to one 1. The causes of the overall high incidence and the particularly high incidence in young people remain unknown and will require detailed epidemiologic studies of the local population.

Competing Interests: The authors have declared that no competing interests exist. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

National Center for Biotechnology Information , U. PLoS One. Published online Nov Sonja P. Dawsey , 1 Stanley Tonui , 2 Robert K. Parker , 3 John W. Fitzwater , 4 Sanford M. Dawsey , 1 Russell E. White , 2 , 3 and Christian C. Robert K. John W. Sanford M. Russell E. Christian C. Irene Oi Lin Ng, Editor. Author information Article notes Copyright and License information Disclaimer. Received Jun 16; Accepted Oct Copyright This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.

This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration, which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.

This article has been cited by other articles in PMC. Abstract Certain geographically distinct areas of the world have very high rates of esophageal cancer EC. Introduction Worldwide, esophageal cancer EC ranks eighth in cancer incidence and sixth in cancer mortality [1]. Results Between and , patients 30 years of age or younger were diagnosed with EC at Tenwek Hospital, with the youngest subject 14 years of age.

Open in a separate window. Figure 1. Home villages of young esophageal cancer patients. Figure 2. Survival with esophageal cancer in young patients by sex. Table 4 Published papers presenting information on esophageal cancer in young patients. Histology Date Reference No. Cases Mean Age No. Males No. ESCC No. At 1 year the overall survival was The 5-year survival was An inherent bias in the older population is a higher prevalence of co-morbidities including CAD and diabetes, that will have a significant influence on overall survival.

Of the 35 patients with Stage III disease, 21 patients This finding appears to be consistent with other publications that suggest that younger patients receive more treatment surgical, chemotherapy and radiation when compared to older patients of the same stage 5 , 9 , In reviewing our charts, we found that medical oncologist and radiation oncologist were more likely to suggest adjuvant therapy because of the young age of the patient.

Additionally, we also found that older patients were less likely to want additional treatment even when recommended. We sought to answer two questions in this analysis: I do patients who develop esophageal cancer at a much younger age than expected demonstrate a biologically more aggressive phenotype of the disease compared to older patients?

II Young patients diagnosed with cancer are frequently treated with much more aggressive treatment protocols primarily based on their young age. Is such a practice justified by the outcomes or is it a form of reverse ageism? Our finding that disease-free survival is not statistically significant between the two age groups, suggests that the cancer biology is likely similar regardless of age of diagnosis, and that patients who develop the disease and an unexpected young age do not appear to manifest a more aggressive phenotype of the disease.

Furthermore, the more aggressive treatment strategy that is frequently employed in the younger patient cohort appears to be justified based on the superior survival results observed, particularly in those patients with more advanced stages of disease. The question of young age as a prognostic factor has been explored in different cancer types.

In breast cancer, Xiong et al. A recent publication from Arnold et al. They found that younger patients had better overall survival, especially at the early stages Additionally, the younger patients received more treatment regardless of stage. To our knowledge, this is the only study that demonstrates the significance of age in esophageal cancer after matching patients based on significant pre-operative factors. We acknowledge several limitations of this publication.

This is a retrospective study limited to one institution. Additionally, we acknowledge that matching does not completely eliminate confounding factors on survival. For example, we were not able to match on type of surgery Ivor Lewis esophagectomy vs. Asked for his perspective, Hashem B. He said that so far he has not seen an uptick at his center since the case numbers are too few.

As to possible drivers of the trend, he noted rising obesity rates in younger individuals leading in turn to chronic gastroesophageal reflux disease [GERD] at an early age. Also speculating about possible reasons for the increase, Iyer and co-authors wrote: "While it is unclear at this time what biologic, genetic, or environmental factors may influence these findings, until such factors are elucidated, reevaluation of our diagnostic and treatment strategies in this age group might need to be considered.

Limitations of this study, the team said, included the inability to thoroughly review individual health records to confirm disease stage and other patient variables at diagnosis, and there was also a disproportionate number of cases in white patients, which precluded true comparison of outcomes across races.