J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text HTML] [Full Text PDF] （in Japanese / 1787KB） [PDF: Members Only]

J.Jpn. Surg. Soc.. 121(4): 410-416, 2020

Feature topic

EPIDEMIOLOGY AND RISK FACTORS IN JAPANESE ESOPHAGEAL CANCER

1) Department of Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Japan
2) Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Japan
3) Division of Epidemiology, Center for Public Health Sciences, National Cancer Center, Maebashi, Japan

Tatsuya Miyazaki1), Makoto Sakai2), Makoto Sohda2), Taiki Yamaji3), Hiroshi Saeki2)

In Japan, the incidence of esophageal cancer is steadily increasing among men but is nearly stable in women. In addition, the mortality rate has been declining slowly in men and has declined in women, with a gender ratio of 5:1. Esophageal cancer is most prevalent in patients in their 60s and 70s. The most common lesion site is the mid-thoracic esophagus, and the most common histological type is squamous cell carcinoma (90％). Surgery is the most common treatment, in about 60％ of patients, followed by chemoradiation (22％) and endoscopy (18％). The 5-year overall survival rates of patients who underwent surgical treatment were:p stage 0, 85.2％;I, 80.2％;II, 62.3％;III, 36.1％;IVa, 20.1％; and IVb, 21.6％. Smoking and alcohol consumption are major risk factors for esophageal squamous cell carcinoma, and the risk increases with combined tobacco and alcohol use. It was reported that among those who have a genetic polymorphism of aldehyde dehydrogenase 2 (ALDH2), which is found in 20–40％ of Japanese, those classified as heavy drinkers are at especially high risk. In addition, a high frequency of double cancer is seen in esophageal cancer patients, and in particular malignant tumors with common risk factors often occur simultaneously. It is necessary to understand these characteristics thoroughly to perform appropriate diagnosis, treatment, and follow-up of patients with esophageal cancer.

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