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食管癌的流行病学:全球趋势、病因和危险因素的最新进展。

Epidemiology of esophageal cancer: update in global trends, etiology and risk factors.

机构信息

Department of Internal Medicine, MercyOne Des Moines Medical Center, 1111 6th Avenue, Des Moines, IA, 50314, USA.

Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, 121 Dekalb Avenue, Brooklyn, NY, 11201, USA.

出版信息

Clin J Gastroenterol. 2020 Dec;13(6):1010-1021. doi: 10.1007/s12328-020-01237-x. Epub 2020 Sep 23.

Abstract

Esophageal cancer is the eighth most common type of cancer worldwide and constitutes the sixth leading cause of cancer deaths. It is characterized by its high mortality rate, poor prognosis at time of diagnosis and variability based on geographic location. Present day, the prevalence of esophageal cancer is in transition. Although esophageal squamous cell carcinoma continues to be the most prevalent type worldwide, esophageal adenocarcinoma is quickly becoming the most prevalent type in developed countries. Risk factors for the development of esophageal squamous cell carcinoma include low socioeconomic status, consumption of tobacco, alcohol, hot beverages, and nitrosamines. Additionally, micronutrient deficiencies have also been linked to the development of esophageal squamous cell cancer. These include vitamin C, vitamin E, and folate. With respect to esophageal adenocarcinoma, risk factors include Barrett's esophagus, gastroesophageal reflux disease, obesity, and tobacco consumption. Screening for esophageal cancer will likely play an essential role in prevention, and consequently, mortality in the future. Present day, there are no established guidelines for esophageal squamous cell cancer screening. Guidelines for esophageal adenocarcinoma are more well established but lack concrete evidence in the form of randomized controlled trials. This review will discuss the epidemiology, risk factors, and current prevention strategies for esophageal cancer in depth. It is our aim to raise awareness on the aforementioned topics to increase public health efforts in eradicating this disease.

摘要

食管癌是全球第八大常见癌症类型,也是第六大癌症死亡原因。其特点是死亡率高、诊断时预后差以及因地理位置不同而存在差异。如今,食管癌的患病率正在发生转变。虽然食管鳞状细胞癌仍然是全球最常见的类型,但食管腺癌在发达国家迅速成为最常见的类型。食管鳞状细胞癌的发展危险因素包括社会经济地位低、吸烟、饮酒、饮用热饮和亚硝胺。此外,微量元素缺乏也与食管鳞状细胞癌的发展有关。这些包括维生素 C、维生素 E 和叶酸。对于食管腺癌,危险因素包括巴雷特食管、胃食管反流病、肥胖和吸烟。食管癌的筛查可能在未来的预防和死亡率方面发挥重要作用。目前,尚无针对食管鳞状细胞癌筛查的既定指南。食管腺癌的指南更为完善,但缺乏随机对照试验形式的具体证据。本综述将深入讨论食管癌的流行病学、危险因素和当前预防策略。我们的目的是提高对上述主题的认识,以加强消除这种疾病的公共卫生工作。

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