Patients with Achalasia Have an Increased Risk of Esophageal Cancer, Study Reveals

A recent study reveals that achalasia is correlated with an increased risk of developing both squamous cell carcinoma and adenocarcinoma of the esophagus; however, the annual incidence of the esophageal cancer is rather low.


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What is achalasia?

Achalasia is a medical condition where the esophagus is incapable to move food into the stomach. The lower esophageal sphincter (LES), a valve which is located at the end of the esophagus, remains closed during swallowing, which results in the backing up of food. Prevalent symptoms may include vomiting undigested food, chest pain, heartburn, and weight loss.


Researchers conducted a long-term prospective group study to assess the risk of both squamous cell carcinoma and adenocarcinoma of the esophagus in patients with primary achalasia. Between 1973 and 2018, researchers followed these patients by the same protocol which included upper endoscopy with esophageal biopsies.


Using Standardized Incidence Ratios (SIRs) with 95% confidence interval to estimate the relative risk of esophageal cancer in patients with achalasia relative to the gender and age-matched general populace.


In general, 566 patients with achalasia (with average age at diagnosis, 48.1 years; 46% were men) were followed for an average of 15.5 years since diagnosis. There were 20 of the patients (15 were men) developed esophageal cancer – 15 squamous cell carcinoma and 5 adenocarcinomas.


Achalasia patients had a significantly higher risk of esophageal cancer than the general populace, both for squamous cell carcinoma, and adenocarcinoma. Particularly, men revealed a higher risk of developing esophageal cancer than in women.


Moreover, the annual incidence rate of esophageal cancer was only 0.24%, which was higher for squamous cell carcinoma (0.18%) than adenocarcinoma (0.06%).


Researchers also said, “These findings may have implications for endoscopic surveillance of patients with achalasia.” For complete details of the study, you may click here.

 

Source: Am J Gastroenterol 2021;116:289-295

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