What is the most common histological type of esophageal cancer?

From the Guidelines

The most common histological type of esophageal cancer worldwide is squamous cell carcinoma (SCC), which accounts for approximately 90% of all esophageal cancer cases globally. While adenocarcinoma has become the predominant type in the United States and some Western countries in recent decades, squamous cell carcinoma remains far more prevalent when considering the global burden of esophageal cancer 1. This geographical variation reflects different risk factor exposures, with SCC being strongly associated with tobacco use, alcohol consumption, and consumption of very hot beverages, factors that are widespread in many high-incidence regions such as parts of Asia, Africa, and South America. In contrast, adenocarcinoma is more closely linked to gastroesophageal reflux disease, Barrett's esophagus, and obesity, which are increasingly common in Western populations. The other histological types mentioned - leiomyosarcoma and lymphoma - are relatively rare forms of esophageal cancer, accounting for only a small percentage of cases.

Some key points to consider:

• The global incidence rates of esophageal cancer vary significantly, with rates ranging from 0.8 in Western Africa to 17.0 in Eastern Asia in men, and 0.2 in Micronesia/Polynesia to 7.8 in Eastern Africa in women 1.
• The regional variations in the incidences and type of oesophageal cancer are driven by differences in risk factors, although for some regions these are not fully understood 1.
• The incidence of SCCs is decreasing in Europe and North America, while the incidence of oesophageal adenocarcinomas has been increasing in North America and Western countries such as Australia, France and England 1.
• Helicobacter pylori (H. pylori) infection and CagA-positive strains are associated with a decreased risk of oesophageal adenocarcinoma 1.

Overall, squamous cell carcinoma is the most common histological type of esophageal cancer worldwide, and its prevalence is closely linked to geographical and lifestyle factors 1.

From the Research

Histological Types of Oesophageal Cancer

• The most common histological types of oesophageal cancer are squamous cell carcinoma (SCC) and adenocarcinoma (AC) 2, 3, 4, 5.
• Globally, squamous cell carcinoma remains the most common histological type 3, 4.
• In Western countries, however, adenocarcinoma has become the leading histological subtype, corresponding to a rise in the incidence of obesity, gastro-esophageal reflux disease, and Barrett's esophagus 3.

Geographical Distribution

• The incidence of squamous cell carcinoma is higher in Central and Southeast Asia, Eastern and Southern Africa, and South America 4.
• Adenocarcinoma is more prevalent in North America and Western Europe 5.

Risk Factors

• Common risk factors associated with squamous cell carcinoma include tobacco smoking and excessive alcohol consumption 4.
• Dietary factors, genetic factors, microorganisms, and some other environmental factors may also contribute to the etiopathogenesis of the disease 4.