Journal of the Formosan Medical Association
Volume 109, Issue 6 , Pages 408-421, June 2010

Secondary Prevention of Esophageal Squamous Cell Carcinoma in Areas Where Smoking, Alcohol, and Betel Quid Chewing are Prevalent

  • Chen-Shuan Chung

      Affiliations

    • Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
    • Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
    • Chen-Shuan Chung and Yi-Chia Lee contributed equally to this work.
    • ,
  • Yi-Chia Lee

      Affiliations

    • Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
    • Chen-Shuan Chung and Yi-Chia Lee contributed equally to this work.
    • ,
  • Cheng-Ping Wang

      Affiliations

    • Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
    • Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Jenq-Yuh Ko

      Affiliations

    • Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
    • ,
  • Wen-Lun Wang

      Affiliations

    • Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
    • Department of Internal Medicine, E-DA Hospital and I-Shou University, Kaohsiung, Taiwan
    • ,
  • Ming-Shiang Wu

      Affiliations

    • Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Ming-Shiang Wu, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan, South Road, Taipei, Taiwan
    • ,
  • Hsiu-Po Wang

      Affiliations

    • Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Hsiu-Po Wang, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan, South Road, Taipei, Taiwan

Article Outline

Esophageal cancer is ranked as the sixth most common cause of cancer death worldwide and has a substantial effect on public health. In contrast to adenocarcinoma arising from Barrett's esophagus in Western countries, the major disease phenotype in the Asia-Pacific region is esophageal squamous cell carcinoma which is attributed to the prevalence of smoking, alcohol, and betel quid chewing. Despite a multidisciplinary approach to treating esophageal cancer, the outcome remains poor. Moreover, field cancerization reveals that esophageal squamous cell carcinoma is closely linked with the development of head and neck cancers that further sub-optimize the treatment of patients. Therefore, preventive strategies are of paramount importance to improve the prognosis of this dismal disease. Since obstacles exist for primary prevention via risk factor elimination, the current rationale for esophageal cancer prevention is to identify high-risk groups at earlier stages of the disease, and encourage them to get a confirmatory diagnosis, prompt treatment, and intensive surveillance for secondary prevention. Novel biomarkers for identifying specific at-risk populations are under extensive investigation. Advances in image-enhanced endoscopy do not just substantially improve our ability to identify small precancerous or cancerous foci, but can also accurately predict their invasiveness. Research input from the basic sciences should be translated into preventive measures in order to decrease the disease burden of esophageal cancer.

Key Words:  areca nut , betel quid , cancer prevention , esophageal cancer , image-enhanced endoscopy

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PII: S0929-6646(10)60072-1

doi:10.1016/S0929-6646(10)60072-1

Journal of the Formosan Medical Association
Volume 109, Issue 6 , Pages 408-421, June 2010

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