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
peopleFrankie Boyle responds to referendum result in characteristically offensive style
Sport
Lewis Hamilton will start the Singapore Grand Prix from pole, with Nico Rosberg second and Daniel Ricciardo third
F1... for floodlit Singapore Grand Prix
Arts and Entertainment
'New Tricks' star Dennis Waterman is departing from the show after he completes filming on two more episodes
tvHe is only remaining member of original cast
Arts and Entertainment
tvHighs and lows of the cast's careers since 2004
PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Sport
Fans hold up a scarf at West Ham vs Liverpool
footballAfter Arsenal's clear victory, focus turns to West Ham vs Liverpool
New Articles
i100... she's just started school
News
news
New Articles
i100
Life and Style
Couples have been having sex less in 2014, according to a new survey
life
Arts and Entertainment
musicBiographer Hunter Davies has collected nearly a hundred original manuscripts
Sport
football
New Articles
i100... despite rising prices
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

    Qualified Primary Teaching Assistant

    £64 - £73 per day + Competitive rates based on experience : Randstad Education...

    Primary KS2 NQTs required in Lambeth

    £117 - £157 per day + Competitive London rates: Randstad Education Group: * Pr...

    Primary NQTs required in Lambeth

    £117 - £157 per day + Competitive London rates: Randstad Education Group: * Pr...

    Primary NQTs required in Lambeth

    £117 - £157 per day + Competitive London rates: Randstad Education Group: * Pr...

    Day In a Page

    Scottish referendum: The Yes vote was the love that dared speak its name, but it was not to be

    Despite the result, this is the end of the status quo

    Boyd Tonkin on the fall-out from the Scottish referendum
    Manolo Blahnik: The high priest of heels talks flats, Englishness, and why he loves Mary Beard

    Manolo Blahnik: Flats, Englishness, and Mary Beard

    The shoe designer who has been dubbed 'the patron saint of the stiletto'
    The Beatles biographer reveals exclusive original manuscripts of some of the best pop songs ever written

    Scrambled eggs and LSD

    Behind The Beatles' lyrics - thanks to Hunter Davis's original manuscript copies
    'Normcore' fashion: Blending in is the new standing out in latest catwalk non-trend

    'Normcore': Blending in is the new standing out

    Just when fashion was in grave danger of running out of trends, it only went and invented the non-trend. Rebecca Gonsalves investigates
    Dance’s new leading ladies fight back: How female vocalists are now writing their own hits

    New leading ladies of dance fight back

    How female vocalists are now writing their own hits
    Mystery of the Ground Zero wedding photo

    A shot in the dark

    Mystery of the wedding photo from Ground Zero
    His life, the universe and everything

    His life, the universe and everything

    New biography sheds light on comic genius of Douglas Adams
    Save us from small screen superheroes

    Save us from small screen superheroes

    Shows like Agents of S.H.I.E.L.D are little more than marketing tools
    Reach for the skies

    Reach for the skies

    From pools to football pitches, rooftop living is looking up
    These are the 12 best hotel spas in the UK

    12 best hotel spas in the UK

    Some hotels go all out on facilities; others stand out for the sheer quality of treatments
    These Iranian-controlled Shia militias used to specialise in killing American soldiers. Now they are fighting Isis, backed up by US airstrikes

    Widespread fear of Isis is producing strange bedfellows

    Iranian-controlled Shia militias that used to kill American soldiers are now fighting Isis, helped by US airstrikes
    Topshop goes part Athena poster, part last spring Prada

    Topshop goes part Athena poster, part last spring Prada

    Shoppers don't come to Topshop for the unique
    How to make a Lego masterpiece

    How to make a Lego masterpiece

    Toy breaks out of the nursery and heads for the gallery
    Meet the ‘Endies’ – city dwellers who are too poor to have fun

    Meet the ‘Endies’ – city dwellers who are too poor to have fun

    Urbanites are cursed with an acronym pointing to Employed but No Disposable Income or Savings
    Paisley’s decision to make peace with IRA enemies might remind the Arabs of Sadat

    Ian Paisley’s decision to make peace with his IRA enemies

    His Save Ulster from Sodomy campaign would surely have been supported by many a Sunni imam