Gastric & oesophageal adenocarcinoma

One in every eight cancers in the world develops in the oesophagus or stomach. While the incidence of gastric adenocarcinoma and oesophageal squamous cell carcinoma have declined in recent decades, oesophageal adenocarcinoma has increased more than any other cancer. Infection with Helicobacter pylori, dietary salt and smoking are the main risk factors for gastric and oesophageal cancer. Gastro-oesophageal reflux disease (GORD), Barrett’s oesophagus and obesity are risk factors for oesophageal adenocarcinoma. Adenocarcinomas of the oesophago-gastric junction and cardia include two distinct types, one resembling gastric cancer caused by H.pylori infection, the other, associated with GORD, resembling Barrett’s adenocarcinoma. Gender is also a major intrinsic factor, with upper gastrointestinal cancer much commoner in men. The current work examines this male predominance at the population level and with reference to Lauren histological type, showing that only intestinal-type but not diffuse type upper GI cancers occur more frequently in men.