Obesity may be behind big rise in cancer of the gullet

Heartburn also linked to condition which is killing more British males every year

A genetic mutation triggered by the obesity epidemic could lie behind the dramatic increase in a type of cancer which is affecting the UK more than any other nation.

Cancer of the oesophagus – or gullet – has been rising in all western countries as a result of a change in the nature of the disease. In the UK, the rate has risen by 50 per cent over the past 25 years, with around 8,500 new cases a year.

The cancer affects the foodpipe which extends around 26cm from the mouth to the stomach. It has one of the poorest survival rates of any cancer, with more than eight out of 10 patients dying within five years.

But whereas 40 years ago most cases were of squamous cell cancer which starts in the upper part of the oesophagus and is linked with smoking and drinking, today most cases are of adenocarcinoma, starting at the base of the oesophagus where the gullet meets the stomach.

Cases of adenocarcinoma have risen ten-fold over the past 40 years in the UK and it is now five times more common than squamous cell cancer, rates of which have remained stable. Among white men, the UK incidence of adenocarcinoma of the oesophagus is the highest in the world. Now a team led by scientists from the Dana Farber Cancer Institute in the US has found adenocarcinoma is linked with heartburn. A series of genetic mutations in tissue samples taken from patients with this type of cancer suggest it is caused by acid reflux.

Gad Getz, of the Massachusetts General Hospital and a lead author of the study published in Nature Genetics, said: "We discovered a pattern of DNA changes that had not been seen before in any other cancer type."

His colleague, Adam Bass of Dana Farber and the Broad Institute, added: "Gastric reflux can produce this type of damage, suggesting that reflux may underlie this pattern of mutations."

The oesophagus has a sphincter at its base to prevent the acid in the stomach gurgling back into it, damaging the lining and causing heartburn. In some men the sphincter ceases to work properly, a problem aggravated by obesity, allowing the lining to be eaten away which in turn may lead to cancer.

Men are almost three times more likely to develop adenocarcinoma than women partly because they have more severe reflux and because they are more likely to have excess weight around their waist rather than their hips – the apple vs pear shape – which increases the rate of reflux. Overall rates of oesophageal cancer – squamous cell and adenocarcinoma combined – are still higher among French men than British men. In Brittany it has been blamed on the "Calvados effect", the apple brandy made in that region.

The US scientists who sequenced sections of DNA in tissue samples taken from 149 patients with adenocarcinoma found 26 genes that were frequently mutated, indicating the cause was acid damage.

Dr Bass said: "Identifying the mutated genes within these tumours will help us understand the underlying biology. It also presents us with a slate of known genetic abnormalities that can some day be used to diagnose the disease at an early stage, classify tumours by the particular mutations, and ultimately develop treatment geared to precisely those mutations."

8,500 New cases of cancer of the oesophagus every year

News
peopleHowards' Way actress, and former mistress of Jeffrey Archer, was 60
Sport
Romelu Lukaku puts pen to paper
sport
News
Robyn Lawley
people
Arts and Entertainment
Unhappy days: Resistance spy turned Nobel prize winner Samuel Beckett
books
PROMOTED VIDEO
Life and Style
ebookA wonderful selection of salads, starters and mains featuring venison, grouse and other game
News
people
Life and Style
Troy Baker and Ashley Johnson voice the show’s heroes
gamingOnce stilted and melodramatic, Hollywood is giving acting in video games a makeover
News
i100
Life and Style
Phones will be able to monitor your health, from blood pressure to heart rate, and even book a doctor’s appointment for you
techCould our smartphones soon be diagnosing diseases via Health Kit and Google Fit?
News
people
Extras
indybest
Travel
Ryan taming: the Celtic Tiger carrier has been trying to improve its image
travelRyanair has turned on the 'charm offensive' but can we learn to love the cut-price carrier again?
Sport
Usain Bolt confirms he will run in both the heats and the finals of the men's relay at the Commonwealth Games
commonwealth games
Life and Style
Slim pickings: Spanx premium denim collection
fashionBillionaire founder of Spanx launches range of jeans that offers 'thigh-trimming construction'
News
Sabina Altynbekova has said she wants to be famous for playing volleyball, not her looks
people
News
i100
Life and Style
tech'World's first man-made leaves' could use photosynthesis to help astronauts breathe
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    SAP Project Manager

    competitive: Progressive Recruitment: SAP PROJECT MANAGER - 3 MONTHS - BERKSHI...

    SAP Project Manager

    competitive: Progressive Recruitment: SAP PROJECT MANAGER - 3 MONTHS - BERKSHI...

    Senior Investment Accounting Change Manager

    £600 - £700 per day + competitive: Orgtel: Senior Investment Accounting Change...

    Microsoft Dynamics AX Functional Consultant

    £65000 - £75000 per annum + benefits: Progressive Recruitment: A rare opportun...

    Day In a Page

    Save the tiger: The day America’s love of backyard tigers led to a horrific bloodbath

    The day America’s love of backyard tigers led to a horrific bloodbath

    With only six per cent of the US population of these amazing big cats held in zoos, the Zanesville incident in 2011 was inevitable
    Samuel Beckett's biographer reveals secrets of the writer's time as a French Resistance spy

    How Samuel Beckett became a French Resistance spy

    As this year's Samuel Beckett festival opens in Enniskillen, James Knowlson, recalls how the Irish writer risked his life for liberty and narrowly escaped capture by the Gestapo
    We will remember them: relatives still honour those who fought in the Great War

    We will remember them

    Relatives still honour those who fought in the Great War
    Star Wars Episode VII is being shot on film - and now Kodak is launching a last-ditch bid to keep celluloid alive

    Kodak's last-ditch bid to keep celluloid alive

    Director J J Abrams and a few digital refuseniks shoot movies on film. Simon Usborne wonders what the fuss is about
    Once stilted and melodramatic, Hollywood is giving acting in video games a makeover

    Acting in video games gets a makeover

    David Crookes meets two of the genre's most popular voices
    Could our smartphones soon be diagnosing diseases via Health Kit and Google Fit?

    Could smartphones soon be diagnosing diseases?

    Health Kit and Google Fit have been described as "the beginning of a health revolution"
    Ryanair has turned on the 'charm offensive' but can we learn to love the cut-price carrier again?

    Can we learn to love Ryanair again?

    Four recent travellers give their verdicts on the carrier's improved customer service
    Billionaire founder of Spanx launches range of jeans that offers

    Spanx launches range of jeans

    The jeans come in two styles, multiple cuts and three washes and will go on sale in the UK in October
    10 best over-ear headphones

    Aural pleasure: 10 best over-ear headphones

    Listen to your favourite tracks with this selection, offering everything from lambskin earmuffs to stainless steel
    Commonwealth Games 2014: David Millar ready to serve up gold for his beloved Scotland in the end

    Commonwealth Games

    David Millar ready to serve up gold for his beloved Scotland in the end
    UCI Mountain Bike World Cup 2014: Downhill all the way to the top for the Atherton siblings

    UCI Mountain Bike World Cup

    Downhill all the way to the top for the Atherton siblings
    Save the tiger: The animals bred for bones on China’s tiger farms

    The animals bred for bones on China’s tiger farms

    The big cats kept in captivity to perform for paying audiences and then, when dead, their bodies used to fortify wine
    A former custard factory, a Midlands bog and a Leeds cemetery all included in top 50 hidden spots in the UK

    A former custard factory, a Midlands bog and a Leeds cemetery

    Introducing the top 50 hidden spots in Britain
    Ebola epidemic: Plagued by fear

    Ebola epidemic: Plagued by fear

    How a disease that has claimed fewer than 2,000 victims in its history has earned a place in the darkest corner of the public's imagination
    Chris Pratt: From 'Parks and Recreation' to 'Guardians of the Galaxy'

    From 'Parks and Recreation' to 'Guardians of the Galaxy'

    He was homeless in Hawaii when he got his big break. Now the comic actor Chris Pratt is Hollywood's new favourite action star