Diseases / Research

Esophageal Cancer

Esophageal Cancer

Histological section of a well differentiated esophageal cancer (purple cells) invading the submucosa.

Photo by Fred Hutch

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Fred Hutch researchers are advancing strategies for preventing the disease for esophageal cancer and a related condition called Barrett’s esophagus. Hutch conducted one of the first and longest studies looking at the role of aspirin and antinflammatories and their role in reducing risk for esophagus cancer. Our researchers are part of an  international group of investigators who pool data and resources to investigate possible causes of the conditions and ways to prevent it.

Scientists are also working toward discoveries that improve the quality of life and care for patients living with these conditions.

 

 


Fast Facts

  • Esophageal cancer affects the esophagus—the hollow, muscular tube that carries food and liquids from the throat to the stomach. Adenocarcinoma is the most common type of esophageal cancer; it has been increasing in incidence more rapidly than any type of cancer in the United States.
  • The causes of adenocarcinoma are diverse, but are led by obesity, smoking and gastroesophageal reflux, a problem in which stomach contents frequently back up into the esophagus. By far, tobacco and alcohol use are the strongest risk factors for esophageal squamous cell carcinoma, accounting for about 90 percent of such cases.
  • People with a precancerous condition called Barrett's esophagus face a far greater than average risk of developing esophageal cancer, although most people with Barrett's do not go on to develop cancer. Barrett's esophagus occurs when tissues at the bottom of the esophagus become inflamed as a result of reflux. Over time, this inflamed part of the esophagus may change and begin to resemble the cells that line the small intestine.

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Prevention & Causes

Fred Hutch plays a leading role in identifying esophageal cancer's causes, laying the foundation for new ways to prevent the disease. Our researchers are:

Linking obesity to Barrett's esophagus – Abdominal obesity is a strong risk factor for Barrett's esophagus, according to a study led by Dr. Thomas Vaughan and colleagues. Vaughan's study was one of the first to look at the association between Barrett’s espophagus and multiple measures of obesity. The observations suggest weight loss might help prevent Barrett's esophagus and esophageal cancer. Learn more >

Preventing Barrett’s esophagus from becoming cancer – In the first and longest observational study of its kind, Dr. Vaughan and colleagues found that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may significantly reduce the risk of esophageal cancer among people with Barrett's esophagus. Learn more >

Identifying genetic causes – Our researchers have also identified a cluster of genetic abnormalities, or biomarkers, in people with Barrett's esophagus that significantly increases the risk of developing esophageal cancer. A Hutchinson Center study found that patients who had three or more of the biomarkers and used NSAIDs had a 30 percent risk of esophageal cancer after 10 years. By contrast, those with the same abnormalities who did not use NSAIDs had a 79 percent risk of developing cancer 10 years after the study. Learn more >

Unraveling how risk factors work together – Dr. Vaughan is leading a study that investigates how a person’s genetic susceptibility for esophageal adenocarcinoma – the most common esophageal cancer in the U.S. – interacts with smoking, obesity and other outside factors to impact their risk of developing the disease and/or Barrett’s esophagus. Learn more >

 

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Treatment & Prognosis

Improving the lives of patients with Barrett's esophagus and esophageal cancer – Fred Hutch is home to the Seattle Barrett's Esophagus Research Program where our scientists work with colleagues at other institutions to improve the lives of patients living with Barrett’s esophagus. The program includes clinicians who care for patients, researchers investigating how Barrett's esophagus leads to esophageal cancer and epidemiologists who explore risk factors that may cause Barrett's esophagus and cancer.

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Improving Survival

Boosting survival rates – A team of Hutch investigators has shown that a systematic, multidisciplinary approach to early cancer detection can significantly boost the five-year survival rate for esophageal cancer. The investigators are founders and active members of the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON), an international group of investigators who pool data and resources to investigate possible causes of the conditions and ways to prevent it.

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