Gastro-oesophageal cancer: death at the junction

doi:10.1136/bmj.321.7259.463

BMJ 2000;321:463-464 ( 19 August )

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Gastro-oesophageal cancer: death at the junction

Understanding changes at molecular level could lead to screening opportunities

The first 150 words of the full text of this article appear below.

The death rates from cancers of the oesophagus and gastro-oesophageal junction, adjusted for age, have risen steadily sincethe early 1970s (from 3 to 6 per 100 000 and from 1.5 to 3 per100 000 population in the United Kingdom respectively).¹ Thesefigures are comparable to those in northern Europe and the UnitedStates. The incidence of Barrett's adenocarcinoma in the UnitedStates has increased from 0.3 per 100 000 to 2.3 per 100 000 overthe past threedecades.

Despite improvements in multimodality therapy, especially chemotherapy regimens of combined epirubicin, cisplatin, and fluorouracilcombined with surgery, survival has not improved significantly,suggesting that alternative strategies for identifying and treatingthese conditions areneeded.

The incidence of intestinal metaplasia of both the oesophagus (Barrett's oesophagus) and the gastro-oesophageal junction arealso increasing. This metaplastic tissue is believed to have apremalignant potential, and Barrett's oesophagus is related tobile and acid reflux disease.² About 8% of patients undergoingroutine endoscopy and . . . [Full text of this article]

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