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World J Gastrointest Oncol. Apr 15, 2024; 16(4): 1180-1191
Published online Apr 15, 2024. doi: 10.4251/wjgo.v16.i4.1180
Esophageal cancer screening, early detection and treatment: Current insights and future directions
Hong-Tao Qu, Qing Li, Liang Hao, Yan-Jing Ni, Wen-Yu Luan, Zhe Yang, Xiao-Dong Chen, Tong-Tong Zhang, Yan-Dong Miao, Fang Zhang
Hong-Tao Qu, Department of Emergency, Yantai Mountain Hospital, Yantai 264000, Shandong Province, China
Qing Li, Liang Hao, Yan-Jing Ni, Wen-Yu Luan, Zhe Yang, Xiao-Dong Chen, Tong-Tong Zhang, Yan-Dong Miao, Fang Zhang, Cancer Center, Yantai Affiliated Hospital of Binzhou Medical University, The 2nd Medical College of Binzhou Medical University, Yantai 264100, Shandong Province, China
Co-corresponding authors: Yan-Dong Miao and Fang Zhang.
Author contributions: Miao YD conceptualization, writing-review and editing, funding acquisition, and project administration; Zhang F conceptualization, writing-review and editing, supervision; Qu HT performed literature retrieval, writing-original draft; Li Q performed literature retrieval, writing-original draft; Hao L and Ni YJ performed Literature retrieval and data analysis; Luan WY, Yang Z, Chen XD, and Zhang TT software and prepared Figures; Qu HT and Li Q contributed equally to this work. Miao YD and Zhang F were designated as co-corresponding authors. Zhang F was responsible for the formulation or evolution of overarching research goals and aims, specifically critical review, commentary, or revision-including pre-or postpublication stages, management and coordination responsibility for the research activity planning and execution, acquisition of the financial support for the project leading to this publication, while Miao YD was responsible for review and editing the draft, oversight, and leadership responsibility for the research activity planning and execution, including mentorship external to the core team. This designation reflects their equal contributions and shared responsibility in overseeing the project and correspondence related to this research. All authors approved the final manuscript.
Supported by Shandong Province Medical and Health Science and Technology Development Plan Project, No. 202203030713; Clinical Research Funding of Shandong Medical Association-Qilu Specialization, No. YXH2022ZX02031; and Science and Technology Program of Yantai Affiliated Hospital of Binzhou Medical University, No. YTFY2022KYQD06.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fang Zhang, MD, Chief Doctor, Doctor, Professor, Cancer Center, Yantai Affiliated Hospital of Binzhou Medical University, The 2nd Medical College of Binzhou Medical University, No. 717 Jinbu Street, Muping District, Yantai 264100, Shandong Province, China. zhangfang_0127@bzmc.edu.cn
Received: December 19, 2023
Peer-review started: December 19, 2023
First decision: December 27, 2023
Revised: January 9, 2024
Accepted: February 19, 2024
Article in press: February 19, 2024
Published online: April 15, 2024
Abstract

Esophageal cancer ranks among the most prevalent malignant tumors globally, primarily due to its highly aggressive nature and poor survival rates. According to the 2020 global cancer statistics, there were approximately 604000 new cases of esophageal cancer, resulting in 544000 deaths. The 5-year survival rate hovers around a mere 15%-25%. Notably, distinct variations exist in the risk factors associated with the two primary histological types, influencing their worldwide incidence and distribution. Squamous cell carcinoma displays a high incidence in specific regions, such as certain areas in China, where it meets the cost-effectiveness criteria for widespread endoscopy-based early diagnosis within the local population. Conversely, adenocarcinoma (EAC) represents the most common histological subtype of esophageal cancer in Europe and the United States. The role of early diagnosis in cases of EAC originating from Barrett's esophagus (BE) remains a subject of controversy. The effectiveness of early detection for EAC, particularly those arising from BE, continues to be a debated topic. The variations in how early-stage esophageal carcinoma is treated in different regions are largely due to the differing rates of early-stage cancer diagnoses. In areas with higher incidences, such as China and Japan, early diagnosis is more common, which has led to the advancement of endoscopic methods as definitive treatments. These techniques have demonstrated remarkable efficacy with minimal complications while preserving esophageal functionality. Early screening, prompt diagnosis, and timely treatment are key strategies that can significantly lower both the occurrence and death rates associated with esophageal cancer.

Keywords: Esophageal cancer, Screening, Early detection, Treatment, Endoscopic mucosal resection, Endoscopic submucosal dissection

Core Tip: Esophageal cancer, characterized by its aggressive nature and low survival rates, is one of the most common malignant tumors globally. Variations in risk factors between the two primary histological types, squamous cell carcinoma (ESCC) and adenocarcinoma (EAC), affect their incidence and distribution worldwide. While ESCC is prevalent in specific areas like China and meets criteria for cost-effective early diagnosis, EAC is predominant in Europe and the United States, with the role of early diagnosis in cases arising from Barrett's esophagus being a subject of controversy. The disparities in early-stage treatment across different regions are due to varying rates of early diagnosis, with countries like China and Japan advancing in endoscopic techniques for treatment. Early screening, diagnosis, and treatment significantly reduce the incidence and mortality of esophageal cancer.