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

Arts and Entertainment
Kirk Cameron is begging his Facebook fans to give him positive reviews
film
Sport
premier leagueMatch report: Arsenal 1 Man United 2
Arts and Entertainment
Jason goes on a special mission for the queen
tvReview: Everyone loves a CGI Cyclops and the BBC's Saturday night charmer is getting epic
Sport
Jonny May scores for England
rugby unionEngland 28 Samoa 9: Wing scores twice to help England record their first win in six
PROMOTED VIDEO
Life and Style
ebookNow available in paperback
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
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

    Recruitment Genius: Senior Project Manager

    £45000 - £65000 per annum: Recruitment Genius: This is a fantastic opportunity...

    Recruitment Genius: Shopfitter

    Negotiable: Recruitment Genius: This is an opportunity to join a successful an...

    Recruitment Genius: Digital Sales Account Manager

    £25000 - £30000 per annum: Recruitment Genius: A Digital Sales Account Manager...

    Recruitment Genius: Trainee Sales Account Manager

    £20000 - £25000 per annum: Recruitment Genius: A Trainee Sales Account Manager...

    Day In a Page

    Terry Venables: Wayne Rooney is roaring again and the world knows that England are back

    Terry Venables column

    Wayne Rooney is roaring again and the world knows that England are back
    Michael Calvin: Abject leadership is allowing football’s age-old sores to fester

    Abject leadership is allowing football’s age-old sores to fester

    Those at the top are allowing the same issues to go unchallenged, says Michael Calvin
    Four years of excruciating seizures caused by the 1cm tapeworm found burrowing through a man's brain

    You know that headache you’ve got?

    Four years of excruciating seizures caused by the 1cm tapeworm found burrowing through a man's brain
    Travelling to work by scooter is faster than walking and less sweaty than cycling, so why aren’t we all doing it?

    Scoot commute

    Travelling to work by scooter is faster than walking and less sweaty than cycling, so why aren’t we all doing it?
    Paul Robeson: The story of how an American icon was driven to death to be told in film

    The Paul Robeson story

    How an American icon was driven to death to be told in film
    10 best satellite navigation systems

    Never get lost again: 10 best satellite navigation systems

    Keep your vehicle going in the right direction with a clever device
    Paul Scholes column: England must learn to keep possession and dictate games before they are exposed by the likes of Germany and Brazil

    Paul Scholes column

    England must learn to keep possession and dictate games before they are exposed by the likes of Germany and Brazil
    Michael Dawson: I’ll thank Spurs after we win says defender as he prepares to return with Hull

    Michael Dawson: I’ll thank Spurs after we win

    Hull defender faces his struggling former club on Sunday ready to show what they are missing. But he says he will always be grateful to Tottenham
    Frank Warren column: Dr Wu has big plans for the professionals yet he should stick to the amateur game

    Frank Warren column

    Dr Wu has big plans for the professionals yet he should stick to the amateur game
    Synagogue attack: Fear unites both sides of Jerusalem as minister warns restoring quiet could take 'months'

    Terror unites Jerusalem after synagogue attack

    Rising violence and increased police patrols have left residents of all faiths looking over their shoulders
    Medecins sans Frontieres: The Ebola crisis has them in the headlines, but their work goes far beyond West Africa

    'How do you carry on? You have to...'

    The Ebola crisis has Medecins sans Frontieres in the headlines, but their work goes far beyond West Africa
    Isis extends its deadly reach with suicide bombing in Kurdish capital

    Isis extends its deadly reach with suicide bombing in Kurdish capital

    Residents in what was Iraq’s safest city fear an increase in jihadist attacks, reports Patrick Cockburn
    Underwater photography competition winners 2014 - in pictures

    'Mysterious and inviting' shot of diver wins photography competition

    Stunning image of cenote in Mexico takes top prize
    Sir John Major: Negative West End portrayals of politicians put people off voting

    Sir John Major hits out at theatres

    Negative West End portrayals of politicians put people off voting
    Kicking Barbie's butt: How the growth of 3D printing enabled me to make an army of custom-made figurines

    Kicking Barbie's butt

    How the growth of 3D printing enabled toy-designer to make an army of custom-made figurines