'Quiet epidemic' of male cancer in UK

Oesophageal cancer
Image caption Rates are rising in men

Action is needed to fight a "quiet epidemic" of oesophageal cancer, which is on the rise in the UK, particularly among men, cancer experts say.

Men are almost three times more likely than women to get the cancer - one of the biggest gender divides in cancer rates, according to new figures.

Early diagnosis is the key to saving lives, says a Cancer Research UK team.

Scientists are working on ways to detect symptoms earlier and to decipher the genetic code of the cancer.

Poor outcomes

Oesophageal cancer - cancer of the gullet or food pipe - is the ninth most common cancer in the UK.

It is one of the most difficult cancers to detect and treat, with only about one in 10 patients surviving for 10 years or more.

Latest figures show 5,600 UK men (almost 15 out of every 100,000) developed the disease in 2010, compared with 2,800 UK women (about five out of every 100,000).

This equates to a lifetime risk of one in 56 for men and one in 110 for women.

There are two types of oesophageal cancer:

  • squamous cell carcinoma - linked to smoking, drinking and a low fruit intake
  • adenocarcinoma - linked to obesity, smoking and persistent acid reflux

Researchers believe a steady rise in the number of adenocarcinomas in men is behind the gender gap.

Tim Underwood, an oesophageal surgeon and researcher at the University of Southampton, said many questions remained unanswered about the cancer, but urgent action was needed.

"We need a game changer," he told a news conference.

"And we need a game changer relatively urgently. There is an epidemic of this disease and outcomes are poor."

Mr Underwood, who is running the New York Marathon to raise money for research, said diagnosing the disease earlier was key to improving the chances of survival.

"Food getting stuck when you swallow and persistent heart burn are not normal," he said.

"If this is happening to you, you need to see your GP.

"The vast majority of people won't have anything seriously wrong with them, but it's important to get checked out.

"If left untreated acid reflux - often called heartburn - can damage cells of the oesophagus leading to a condition called Barrett's oesophagus which in turn can be a precursor of oesophageal cancer."

Lifestyle link

Dr Harpal Kumar, chief executive of Cancer Research UK, said the factors behind the rise in oesophageal cancer were unclear.

"We think it may be linked to some changes that we've seen in people's lifestyles, for example increasing levels of obesity," he told BBC News.

"There is a lot more that we need to do to try and understand this disease better, but at this point in time the most important thing is to increase awareness of it and get people to go and see their doctor if they have the symptoms."

Research projects are under way in the UK to understand oesophageal cancer better and develop techniques for earlier diagnosis.

A "sponge-on-a-string" device to collect cells from the gullet for diagnosis could be available on the NHS in five years, said Prof Rebecca Fitzgerald, of the Medical Research Council's Cancer Cell Unit in Cambridge.

The cytosponge test is designed to be swallowed and retrieved to detect pre-cancerous cells.

Clinical trials suggest the test shows promise as a safer and cheaper alternative to endoscopy, a procedure where the inside of the body is examined internally using a long, flexible tube.

"For the patient, this is a five-minute test - it will make your eyes water for two seconds but it is an awful lot simpler, less invasive, safer and cheaper than an endoscopy," said Prof Fitzgerald.

"We're hopeful that in the future this will really transform early diagnosis by making it something much more patient-friendly and affordable."

Prof Fitzgerald said work to decode all of the genes in 500 oesophageal cancer samples, looking for genetic mistakes, was in progress, with about 100 samples completed.

The long-term goal was to develop better drugs for the condition, she said.

Current treatment relies on chemotherapy and radiotherapy, with surgery as an option if the cancer is detected early enough.

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