TAILIEUCHUNG - Chapter 087. Gastrointestinal Tract Cancer

The gastrointestinal tract is the second most common noncutaneous site for cancer and the second major cause of cancer-related mortality in the United States. Esophageal Cancer Incidence and Etiology Cancer of the esophagus is a relatively uncommon but extremely lethal malignancy. The diagnosis was made in 15,560 Americans in 2007 and led to 13,940 deaths. Worldwide, the incidence of esophageal cancer varies strikingly. | Chapter 087. Gastrointestinal Tract Cancer The gastrointestinal tract is the second most common noncutaneous site for cancer and the second major cause of cancer-related mortality in the United States. Esophageal Cancer Incidence and Etiology Cancer of the esophagus is a relatively uncommon but extremely lethal malignancy. The diagnosis was made in 15 560 Americans in 2007 and led to 13 940 deaths. Worldwide the incidence of esophageal cancer varies strikingly. It occurs frequently within a geographic region extending from the southern shore of the Caspian Sea on the west to northern China on the east and encompassing parts of Iran Central Asia Afghanistan Siberia and Mongolia. High-incidence quot pockets quot of the disease are also present in such disparate locations as Finland Iceland Curaẹao southeastern Africa and northwestern France. In North America and western Europe the disease is more common in blacks than whites and in males than females it appears most often after age 50 and seems to be associated with a lower socioeconomic status. A variety of causative factors have been implicated in the development of the disease Table 87-1 . In the United States esophageal cancer cases are either squamous cell carcinomas or adenocarcinomas. The etiology of squamous cell esophageal cancer is related to excess alcohol consumption and or cigarette smoking. The relative risk increases with the amount of tobacco smoked or alcohol consumed with these factors acting synergistically. The consumption of whiskey is linked to a higher incidence than the consumption of wine or beer. Squamous cell esophageal carcinoma has also been associated with the ingestion of nitrites smoked opiates and fungal toxins in pickled vegetables as well as mucosal damage caused by such physical insults as long-term exposure to extremely hot tea the ingestion of lye radiation-induced strictures and chronic achalasia. The presence of an esophageal web in association with glossitis and iron .

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