IARC marks Oesophageal Cancer Awareness Month
The International Agency for Research on Cancer (IARC) observes Oesophageal Cancer Awareness Month in April. During the coming weeks, IARC will highlight some of the projects that the Agency’s scientists are engaged in to prevent oesophageal cancer. IARC estimated that in 2018, oesophageal cancer accounted for almost 573 000 new cases and more than 508 000 deaths globally. Oesophageal cancer is the eighth most common cancer type but the sixth most common cause of cancer death worldwide.
Read moreQ&A with Dr Valerie McCormack
Oesophageal Cancer Awareness Month 2020: Dr Valerie McCormack describes some of IARC’s activities to prevent this disease
Dr Valerie McCormack of the Section of Environment and Radiation at IARC describes one of the main IARC research projects studying oesophageal cancer, with the goals of understanding the causes of this cancer type and identifying strategies to prevent the disease.
1. Can you describe the project?
Cancer of the oesophagus, or the food pipe, has two major types. Worldwide, the main type, called squamous cell carcinoma, is common in parts of Asia, Africa, and South America. In the past decade, as part of a broad programme of work on cancer in Africa, the International Agency for Research on Cancer (IARC) initiated research on why this cancer type is so common in East Africa. Our main project is called Oesophageal Squamous Cell Carcinoma African Prevention Research (ESCCAPE). Its central study involves a multi-country case–control study, in which we interview patients with the disease and a comparison healthy group. We are comparing lifestyles, living conditions, and genetics between these two groups to gain insights into factors that might contribute to the development of this disease.
The project has been funded by IARC and the United States National Cancer Institute and is currently supported by World Cancer Research Fund International. The work involves a large team collaboration, including Drs Menya, Mmbaga, Dzamalala, Middleton, and Schüz, across IARC, Moi University in Kenya, the Kilimanjaro Clinical Research Institute in the United Republic of Tanzania, and the College of Medicine in Malawi.
2. How is the population affected by oesophageal cancer?
In East African countries such as Kenya, the United Republic of Tanzania, and Malawi, oesophageal cancer is among the top three most common cancer types in both men and women. This contrasts with West Africa, where the disease is rare. Sadly, patients in their 20s and 30s are sometimes affected by the disease, and the prognosis is poor in most patients. This disease causes incredible suffering, because the tumour obstructs the food pipe and patients cannot swallow.
3. What are the risk factors for oesophageal cancer?
The risk factors for oesophageal cancer that are relevant in Africa include excessive alcohol consumption, tobacco use, consumption of high-temperature food and beverages, and low intake of fruits and vegetables. Markers of risk include low socioeconomic status and poor oral hygiene. Many other suspected or suggested risk factors are still being investigated, such as household air pollution and consumption of contaminated foods.
4. What are you expecting from this study?
We hope the study will enable us to quantify the contribution of known risk factors to this disease in East Africa and to evaluate, often for the first time, the role of new risk factors that are specific to the cultures of East Africa. These include cleaning teeth with charcoal or a chewing stick. Where risks derive from a known carcinogen, we hope to characterize the cultural habits and exposure sources associated with the carcinogen.
5. Do you have preliminary results that you can share?
Preliminary findings from Kenya and the United Republic of Tanzania suggest a contribution of excessive consumption of alcohol, particularly traditional brews and distillations, as a risk factor, especially in men. Poor oral hygiene and hot tea drinking are also emerging as risk factors relevant to East Africa.
6. Why is this study important?
The problem of oesophageal cancer in Africa has been known for more than seven decades, but etiological research has been lacking in most countries. Our research will help to identify the major risk factors contributing to the cancer burden, to inform governments of the prevention strategies needed to reduce the population’s exposure to them.
IARC Fact sheet on oesophageal cancer
View the IARC Fact sheet on oesophageal cancer