Berries in the prevention of esophageal adenocarcinoma

Abstract

Worldwide esophageal cancer is the eighth most commonly diagnosed cancer, with squamous cell carcinoma and adenocarcinoma representing the two major histological types. In the United States, rates of esophageal adenocarcinoma (EAC) have increased over 500% in the last 30 years resulting in EAC being identified as the fastest increasing of all cancer types. Esophageal adenocarcinoma represents the major type of esophageal cancer in the western world today, while rates of squamous cell carcinoma, which is tightly linked to tobacco use, have been steadily declining. The precise reasons for the rapid increase in EAC and the only known precursor lesion, Barrett's esophagus (BE), are still being unraveled. Persistent, symptomatic, reflux of gastric and duodenal contents, known as gastroesophageal disease (GERD), have long been known to correlate with the development of Barrett's esophagus and EAC. Other risk factors for EAC include obesity, animal-based diets, tobacco use, and excess alcohol intake. Conversely, plant-based diets have generally been associated with a reduction of risk for EAC, thereby supporting evaluations of fruits, vegetables, or plant constituents as potential inhibitors of EAC or BE. Esophageal cancer mortality statistics nearly parallel the incidence statistics reflecting the insidious nature of this disease, one in which the 5-year survival rates consistently remain under 20%. Clearly, new treatment and preventive strategies are needed to combat the increase of this deadly malignancy. This chapter will cover the epidemiology of BE and EAC, berries as potential inhibitors of EAC or BE, and specific issues posing challenges to chemoprevention against EAC. © 2011 Springer Science+Business Media, LLC.