Q. What is the Oesophagus?
A. The oesophagus is the proper name for your gullet, the tube running from your mouth down to your stomach. It lies between your windpipe and your spine.
Q. What is cancer of the oesophagus?
A. There are two main types of oesophageal cancer. Cancers found in the upper two-thirds of the oesophagus are usually squamous carcinomas. Cancers of the lower third are usually adenocarcinomas.    These two types of cancers have different types of cells, almost certainly have different causes and need to be treated differently.
Q. How common is oesophageal cancer?
A. Each year there are nearly 15,000 new cases of oesophageal cancer in the USA, nearly 1500 in Canada, nearly 1200 in Australia and 6,000 in the UK. Some countries, such as Turkey, China, India and South Africa have very high rates of this type of cancer. Even within Europe there is a wide variation. The rate in the UK and Ireland is ten times higher than in Greece and Spain. The incidence of adenocarcinoma of the oesophagus has been increasing over the last 20 years, particularly amongst males in Europe and North America.
Q. Who is more likely to get adenocarcinoma of the oesophagus ?
A. The main risk of adenocarcinoma of the oesophagus comes from a condition called Barrett’s oesophagus. This is a type of heartburn, caused by long-term gastric reflux - the stomach contents splashing up into the lower part of the gullet. About one person in a hundred suffers from Barrett’s oesophagus. They are up to 50 times more likely to get oesophageal cancer then normal. The more severe the case of Barrett’s oesophagus, the greater the risk of cancer. Barrett’s oesophagus is about three times more common in men than women and cancer of the oesophagus is twice as common in men as women. Like most cancers, oesophageal adenocarcinoma is more common in older people: the majority of cases are diagnosed in people over 65. Whites are more likely to get this type of cancer then blacks. Higher risk of this cancer has also been associated with smoking, obesity and a diet low in fruit and vegetables.
Q. Who is more likely to get squamous carcinoma of the oesophagus?
A. Smoking and excessive alcohol consumption substantially increase the risk of this type of oesophageal cancer.  Indeed, smoking is thought to be responsible for four in every ten cases. Blacks are more likely to get this cancer than whites. Eating certain preserved and pickled foods, common in China and Iran, have also been linked to a higher risk.
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