The mystery of male dominance in oesophageal cancer and the potential protective role of oestrogen

Chandanos, Evangelos; Lagergren, Jesper

doi:10.1016/j.ejca.2009.09.001

Cited by 49 publications

(48 citation statements)

References 108 publications

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“…Men are reportedly affected more often with oral SCC, but the male-to-female ratio is reported to be decreasing in human oral SCC (Arduino et al, 2008a). Low levels of oestrogen have been associated with the development of human oesophageal SCC (Chandanos and Lagergren, 2009;Wang et al, 2010) and oesophageal SCC is also often related to alcohol and tobacco use, which may be greater in men (Regezi et al, 2003;Barnes et al, 2005).…”

Section: Discussionmentioning

confidence: 97%

Histological Subtypes of Oral Non-tonsillar Squamous Cell Carcinoma in Dogs

Nemec

Murphy

Kass

et al. 2012

Journal of Comparative Pathology

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Section: Discussionmentioning

confidence: 97%

Histological Subtypes of Oral Non-tonsillar Squamous Cell Carcinoma in Dogs

Nemec

Murphy

Kass

et al. 2012

Journal of Comparative Pathology

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“…Oestrogen exerts its biological actions through the activation of two nuclear receptors: ERα and ERβ (Chandanos and Lagergren, 2009). Both ERα and ERβ have been identified in oesophageal tissue (Tiffin et al, 2003;Nozoe et al, 2007;Kalayarasan et al, 2008).…”

Section: Discussionmentioning

confidence: 98%

“…One important observation on oesophageal cancer is that this cancer among men is three to four times more common than among women (Cook et al, 2009;Jemal et al, 2011;Rutegård et al, 2011). However, this difference has not been totally attributed to the known risk factors because Barrett's epithelium, low socioeconomic status, and alcohol and tobacco consumption cannot adequately explain this marked sex difference (Chandanos and Lagergren, 2009;Rashid et al, 2010). It has been hypothesized that hormonal factors might play a role in the aetiology of oesophageal cancer (Mao et al, 2011), which has been supported by several basic studies that have shown that oestrogen may have inhibitory effects on the growth of oesophageal cancer cells (Lagergren and Nyrén, 1998;Chandanos and Lagergren, 2009;Rutegård et al, 2010;Yang et al, 2012).…”

Section: Introductionmentioning

confidence: 96%

Reproductive factors are associated with oesophageal cancer risk: results from a meta-analysis of observational studies

Zhu

Yue

Yuan

et al. 2017

European Journal of Cancer Prevention

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To further evaluate the association between reproductive events and the development of oesophageal cancer, we searched relevant studies using electronic databases (PubMed, ISI Web of Science). Study-specific relative risks with corresponding 95% confidence intervals (CI) in all analyses were used and multiple summary relative risk (SRR) estimates were calculated. We carried out subgroup analyses and used meta-regression techniques to explore potential sources of heterogeneity. Sensitivity analysis was carried out to identify whether pooled results were influenced by individual studies and publication bias was assessed by Begg's funnel plots and the Egger regression asymmetry test. Fourteen studies were eligible for inclusion in the meta-analysis, summarizing a total of 3816 oesophageal cancer cases. We found that age at menopause (SRR=0.70; 95% CI: 0.51-0.95) and hormone replacement therapy (SRR=0.67; 95% CI: 0.56-0.81) had an association with a decreased risk of oesophageal cancer. A similar result was obtained for parity (SRR=0.79; 95% CI: 0.71-0.89) and ever breastfeeding (SRR=0.65; 95% CI: 0.43-0.97). In contrast, postmenopausal status was associated with increased risk (SRR=1.65; 95% CI: 1.28-2.14). No statistically significant link was found with other exposures. Our meta-analysis supports the substantial influence of reproductive factors, which could be causally linked to oesophageal cancer.

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“…A biological basis for this male predominance, supported by results from animal models, is that estrogen is an inhibitor of esophageal carcinogenesis [77]. Abdominal obesity, which occurs more frequently in men than women, also increases the incidence of gastroesophageal reflux and contributes to the higher incidence of EAC and gastric cardia cancer [76]. Another common etiological factor for both EC and gastric cardia cancer, as discussed previously, is the low level of intake of fruits and vegetables (and associated insufficiencies of micronutrients) by the populations at risk.…”

Section: Common Risk and Protective Factors For Ecmentioning

confidence: 96%

“…For example, the incidence rates for ESCC and EAC in men are 3- to 8-fold higher than in women [76]. One contributing factor is tobacco smoking, an etiological factor that is more prevalent among males.…”

Section: Common Risk and Protective Factors For Ecmentioning

confidence: 99%

Etiology and Prevention of Esophageal Cancer

Yang

Chen

2016

Gastrointest Tumors

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Background: Esophageal cancer (EC) occurs commonly, especially in Asia, and is the sixth leading cause of cancer deaths worldwide. Recently, great progress has been made in research on the etiology and prevention of EC. Summary: The major risk factors for esophageal squamous cell carcinoma (ESCC) are tobacco smoking and alcohol drinking, which act synergistically. Dietary parameters, including dietary carcinogens and insufficiency of micronutrients, could also be important risk factors in certain areas. A common etiological factor for both EC and some other cancers are low levels of intake of fruits and vegetables. With improvements in diet and drinking water in developing countries, the incidence of ESCC decreased. However, in economically well-developed countries, the incidence of esophageal adenocarcinoma (EAC) has markedly increased in the past 40 years. The major etiological factor for EAC is gastroesophageal reflux, which is also an etiological factor for gastric cardia adenocarcinoma (GCA). In certain areas of China, the occurrence of GCA is closely related to ESCC. Susceptibility genes for EC are starting to be discovered, and this may help to identify high-risk groups that have more need for preventive measures. Mitigation of the risk factors, early detection and treatment of precancerous lesions are effective approaches for prevention. Smoking cessation, avoidance of excessive alcohol, meat and caloric consumption, increasing physical activity and frequent consumption of vegetables and fruits are prudent lifestyle modifications for the prevention of EC as well as other diseases. Key Message: The etiology of EC includes tobacco smoking, alcohol drinking, low levels of intake of fruits and vegetables as well as gastroesophageal reflux and susceptibility genes. Practical Implications: A healthy lifestyle including smoking cessation, increasing physical activity, consumption of vegetables as well as reduction of alcohol intake and caloric consumption are major approaches to the prevention of EC.

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The mystery of male dominance in oesophageal cancer and the potential protective role of oestrogen

Cited by 49 publications

References 108 publications

Histological Subtypes of Oral Non-tonsillar Squamous Cell Carcinoma in Dogs

Histological Subtypes of Oral Non-tonsillar Squamous Cell Carcinoma in Dogs

Reproductive factors are associated with oesophageal cancer risk: results from a meta-analysis of observational studies

Etiology and Prevention of Esophageal Cancer

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