Are Overweight Teens At Risk For Gastroesophageal Cancer?

Obesity and overweight are increasingly being associated with various chronic medical conditions such as diabetes, cardiovascular disease, and cancer. A recently published study in the scientific journal Cancer shows that Israeli teenagers who were overweight had an increased risk for developing cancer in the esophagus or gastroesophageal junction in their adulthood.

Gastroesophageal Cancer

The esophagus is the hollow tube that connects your throat to the stomach. The lower portion of this tube where it meets the stomach is called the gastro-esophageal (GE) junction and it includes the first two inches of the stomach, which is called the cardia. Although gastroesophageal cancer is classified as a malignancy of the stomach, it behaves more like a malignancy of the esophagus and it is treated like it.

According to the National Cancer Institute, esophageal cancer is the fastest-growing cancer in the U.S., and it is projected that more than 14,000 people will be diagnosed this year with the disease. It has also been noted that in the last three decades there has been a shift in the type of cells affected. While most cancers of the esophagus used to be of the squamous cell type before, most cases now seen involve the glandular tissues (adenocarcinoma).

Esophageal cancer affects people in their mid to late adulthood, mostly males.  Aside from age and sex, various factors have been associated with the disease including obesity, smoking, alcohol consumption, iron deficiency, gastroesophageal reflux disease (GERD), and a condition called Barrett’s esophagus. Some studies also show that people who belong to lower income levels and low educational levels are more likely to be affected.

Symptoms of esophageal and gastroesophageal cancer include difficulty in swallowing, pain with swallowing, frequent heartburn, indigestion, pain behind the breastbone, hoarseness, coughing, and unexplained weight loss.

Body Mass Index and Gastroesophageal Cancer

Research shows that body mass index (BMI) is a significant risk factor associated with the development of esophageal and GE cancer. BMI is a measure of adiposity or amount of body fat measured with regards to one’s weight and height. Studies show that the risk of developing esophageal cancer rises with increasing BMI. Other confounding factors such as tobacco smoking further increase the likelihood of acquiring the disease.

Read More: Being Overweight And Obesity Increase Risk For Heart Attack

One study published in the Journal of the National Cancer Institute found that the magnitude of association between BMI and esophageal cancer was greater among the younger adults than those older than 70 years. A more recent analysis of several other studies involving US and European populations support these findings, finding a positive correlation between BMI and esophageal cancer risk.

Teen BMI And Gastroesophageal Cancer

Obesity and overweight are now considered growing problems among children and adolescents. Many people are also becoming more concerned about increasing health problems among this young group of people. What is more worrisome is that these health issues become chronic problems that children bring into their adulthood such as diabetes, heart problems, and cancer.

These have raised questions on whether the parallel increase in the incidences of weight problems and chronic disease among young people are related or not.

They found that among more than a million male Israelis who were evaluated to join the army, those who were overweight as teenagers were more likely to have the disease after about two decades of follow-up. The adolescents were about 17 years of age during the recruitment period and approximately 12% of them had increased BMIs. Other risk factors that the researchers evaluated included socioeconomic status, educational attainment, and environmental living conditions. However, they did not evaluate other factors such as diet, alcohol consumption, or tobacco use.

How Does Overweight or Obesity Cause Gastroesophageal Cancer?

Scientists who believe they have found a causal relationship between obesity and gastroesophageal and esophageal cancer explain that although the mechanism is yet unclear, gastroesophageal reflux may be a linking factor. Studies show that excessive intra-abdominal fat can cause an increase in intra-abdominal pressure, which can promote backward flow of gastric acids from the stomach to the esophagus (gastroesophageal reflux). This in turn may predispose one to develop a condition called Barrett's esophagus, a forerunner of adenocarcinoma of the esophagus.

Treatment and Outlook

Not everyone who is overweight will develop gastroesophageal reflux disease (GERD) and not everyone who has GERD develops Barrett's esophagus or esophageal cancer. The early stages of esophageal cancer are usually undetected because symptoms do not usually become apparent until the later stages. Late diagnosis and treatment are associated with high mortality rates.

The diagnosis of cancer in the esophagus can be done through biopsy taken during an endoscopic examination of the esophagus. Other tests include blood tests, imaging exams like CT scan or PET scan, and other endoscopic exams to determine whether the cancer has spread to other parts of the body.

Treatment of gastroesophageal and esophageal cancer usually consists of a combination of surgery to remove the tumor, and chemotherapy, radiation, and photodynamic therapy to prevent the spread of cancer cells.

Read More: Risks factors for oesophageal cancer

People are advised to seek medical attention if they experience symptoms of gastroesophageal reflux frequently, including heartburn, burning chest pain, and a feeling of food coming back to the mouth. Other symptoms that need medical evaluation include pain or difficulty in swallowing, hoarseness, spitting out blood when coughing, and unexplained weight loss.

Experts believe, however, that prevention is the best strategy for health. You can lower your risk for esophageal cancer by eating a healthy, balanced diet, avoiding tobacco smoking and excessive alcohol consumption, and treating GERD symptoms.