As well as a dramatic increase in incidence, there has been a change in the histology of the cancer, with most cases now being adenocarcinoma instead of squamous cell carcinoma (SCC).
The latest British figures show that 5100 men were diagnosed with esophageal cancer in 2007, compared with 2600 men in 1983.
The incidence rate is now 14.4 per 100,000 men, which is 50% higher than the rate of 9.6 per 100,000 men in 1983. The most dramatic rise was in men in their 50s, in whom the rate was increased by 67%.
Esophageal cancer has also increased in women, but not as dramatically; there was an 8% increase from 1983 to 2007 (55.1 to 5.5 per 100,000).
Similarly, the incidence of adenocarcinoma has increased by about 350% in the past 30 years in the United States. The disease seems to be "attacking" middle-aged white males in our country.
The reasons behind these increases in esophageal cancer is unclear. Central obesity has certainly increased over the past several decades and obesity is a significant risk factor for reflux. During reflux, the stomach contents migrate up into the esophagus and bathe the esophageal walls in acid and nonacid injurious juices. The chronic damage causes cells to turn over in an abnormal manner producing precancerous cells referred to as intestinal metaplasia. Intestinal metaplasia is also called Barrett's Esophagus and portends a higher risk for the development of esophageal cancer.
Part of the issue with preventing esophageal cancer is that patients who have pre-malignant conditions such as Barrett's esophagus, do not present with typical symptoms. They actually under report their symptoms. Researcher are working, feverishly working to develop new screening methods for esophageal cancer.