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
In 2006, Pluto was reclassified as a 'dwarf planet'
scienceBut will it be reinstated?
News
Jennifer Lawrence at the Vanity Fair Academy Awards party in February 2014
people12 undisclosed female victims are seeking $100m in damages
Voices
4 May 2013: The sun rises over Tower Bridge in London. Temperatures across the UK could be higher than several European holiday destinations by Monday, including parts of Italy and France (Andy Hepburn/PA)
voices
News
people Biographer says cinema’s enduring sex symbol led a secret troubled life
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
Voices
voicesI like surprises - that's why I'm bringing them back to politics, writes Nigel Farage
Arts and Entertainment
Adam Levine plays a butcher who obsessively stalks a woman in Maroon 5's 'Animals' music video
music'Animals' video 'promotes sexual violence against women'
News
Bear and hare woodland scene from John Lewis Christmas advert
newsRetailer breaks with tradition, selling real festive fir trees online for the first time
Arts and Entertainment
Anthony Horowitz will write the next 007 novel
booksAnthony Horowitz to write new instalment in spy series for 2015
Sport
Stunt BMX rider Danny MacAskill
cyclingJaw-dropping video shows Danny MacAskill's latest death-defying BMX stunt
News
British actor Idris Elba is also a DJ and rapper who played Ibiza last summer
people
Sport
Kicking on: Nathaniel Clyne is relishing the challenge of the Premier League after moving from Crystal Palace
footballSurprises include a first ever call-up for one Southampton star
News
news
Voices
Anthony stopped due to the lack of step free access at Mansion House
voices
Travel
Blue Ghost Fireflies in Brevard, North Carolina. Blue Ghost fireflies are unique because they stay lit and only hover about a foot off the ground.
Photo Location: Brevard, North Carolina
travelGallery: The winner of National Geographic's photo contest receives $10,000
News
The moon observed in visible light, topography and the GRAIL gravity gradients
science

...and it wasn't caused by an asteroid crash, as first thought

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

    HR Advisor - East Anglia - Field-based

    £35000 per annum: Ashdown Group: To be considered for this position you will n...

    General Cover Teacher

    £110 - £130 per day: Randstad Education Reading: We have opportunities for Cov...

    Maths Teacher

    £110 - £130 per day: Randstad Education Reading: Maths Teacher required to tea...

    Digital Fundraising Analyst/Web Analyst - West Sussex - Permanent - £30k DOE

    £25000 - £30000 Per Annum Excellent benefits: Clearwater People Solutions Ltd:...

    Day In a Page

    Italian couples fake UK divorce scam on an ‘industrial scale’

    Welcome to Maidenhead, the divorce capital of... Italy

    A look at the the legal tourists who exploited our liberal dissolution rules
    Tom and Jerry cartoons now carry a 'racial prejudice' warning on Amazon

    Tom and Jerry cartoons now carry a 'racial prejudice' warning on Amazon

    The vintage series has often been criticised for racial stereotyping
    An app for the amorous: Could Good2Go end disputes about sexual consent - without being a passion-killer?

    An app for the amorous

    Could Good2Go end disputes about sexual consent - without being a passion-killer?
    Llansanffraid is now Llansantffraid. Welsh town changes its name, but can you spot the difference?

    Llansanffraid is now Llansantffraid

    Welsh town changes its name, but can you spot the difference?
    Charlotte Riley: At the peak of her powers

    Charlotte Riley: At the peak of her powers

    After a few early missteps with Chekhov, her acting career has taken her to Hollywood. Next up is a role in the BBC’s gangster drama ‘Peaky Blinders’
    She's having a laugh: Britain's female comedians have never had it so good

    She's having a laugh

    Britain's female comedians have never had it so good, says stand-up Natalie Haynes
    Sistine Chapel to ‘sing’ with new LED lights designed to bring Michelangelo’s masterpiece out of the shadows

    Let there be light

    Sistine Chapel to ‘sing’ with new LEDs designed to bring Michelangelo’s masterpiece out of the shadows
    Great British Bake Off, semi-final, review: Richard remains the baker to beat

    Tensions rise in Bake Off's pastry week

    Richard remains the baker to beat as Chetna begins to flake
    Paris Fashion Week, spring/summer 2015: Time travel fashion at Louis Vuitton in Paris

    A look to the future

    It's time travel fashion at Louis Vuitton in Paris
    The 10 best bedspreads

    The 10 best bedspreads

    Before you up the tog count on your duvet, add an extra layer and a room-changing piece to your bed this autumn
    Arsenal vs Galatasaray: Five things we learnt from the Emirates

    Arsenal vs Galatasaray

    Five things we learnt from the Gunners' Champions League victory at the Emirates
    Stuart Lancaster’s long-term deal makes sense – a rarity for a decision taken by the RFU

    Lancaster’s long-term deal makes sense – a rarity for a decision taken by the RFU

    This deal gives England a head-start to prepare for 2019 World Cup, says Chris Hewett
    Ebola outbreak: The children orphaned by the virus – then rejected by surviving relatives over fear of infection

    The children orphaned by Ebola...

    ... then rejected by surviving relatives over fear of infection
    Pride: Are censors pandering to homophobia?

    Are censors pandering to homophobia?

    US film censors have ruled 'Pride' unfit for under-16s, though it contains no sex or violence
    The magic of roundabouts

    Lords of the rings

    Just who are the Roundabout Appreciation Society?