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Cancer Risk Assessment for Throat and Esophagus Cancer

The esophagus is the tube that connects the throat to the stomach. Your esophagus helps move the food you swallow from the back of your throat to your stomach to be digested.

Throat cancer refers to the cancer of the voice box, vocal cords and other parts of the throat. Whereas, esophageal cancer is cancer that occurs in the esophagus. It usually begins in the cells that line the inside of the esophagus.

Although esophagus is a part of the throat, the esophageal cancer and throat cancer are not the same, even if many of their symptoms overlap. Each cancer is differentiated by the location of its origin.

Recent genome advancements have made it possible for prediction of throat and esophageal cancers and understanding the risk percentage of throat and esophageal cancers by analysing individual’s gene make up and family history.

Risk Factors of Throat Cancer

Below are listed some of the risk factors for developing throat cancer:

  • Tobacco use
  • Alcohol use
  • Poor nutrition: Diet low in fruits and vegetables; a diet high in salt-cured fish and meat
  • Human papilloma virus infection
  • Genetic syndromes: Example – Dyskeratosis congenital
  • Family history
  • Gender: Men are four times more likely to develop throat cancer than women
  • Age: Risk increases with age (mostly over the age of 65)
  • Other conditions like: Gastroesophageal reflux disease (GERD) and exposure to Epstein-Barr virus (EBV)

Risk Factors of Esophagus Cancer

Some of the risk factors are as follows:

  • Smoking
  • Alcohol consumption
  • Obesity
  • Physical inactivity
  • Age: Risk increases with age. Fewer than 15% of cases are found in people younger than age 55
  • Gender: Men are more likely to get esophageal cancer than women
  • Gastroesophageal reflux disease (GERD)
  • Barrett’s syndrome: It is a serious complication of GERD. There is change in the cell lining of esophagus
  • Achalasia: Difficulty in swallowing is caused due to an esophageal sphincter that won’t relax
  • Poor diet: Insufficient intake of fruits and vegetables
  • History of cancers (mouth, throat, lung cancers)
  • Record of radiation treatment to chest or upper abdomen
  • Record of injury to esophagus: Accidental consumption of lye-based cleaner which can cause serious damage to the esophagus due to chemical burn
  • Human papilloma virus (HPV) infection
  • Family history of throat cancers

Common genes responsible for Throat cancer

Individuals with gene defects (alterations/mutations) have a high risk of throat cancer. Some of the commonly associated genes with oropharynx and hypopharynx cancers (parts of the throat) are:

  • TP53 gene
  • MIR489 (MicroRNA 489) gene
  • NME1 gene
  • EGFR gene
  • CDKN21 gene
  • MIR142 gene
  • ADH1C gene
  • CDH1 gene

Common genes responsible for Esophageal cancer

Some of the esophageal cancer associated genes are:

  • TP53 gene
  • RB1 gene
  • CDKN2A gene
  • RHBDF2 gene
  • DEC1 gene
  • DCC gene
  • DLEC1 gene
  • TGFBR2 gene

Assessment of Throat and Esophagus Cancer Risk

Some of the tests an individual can take to know the possibility of cancer of throat or esophagus are:

  1. Personal history of cancer
  2. Detailed family history
  3. Possible tests for throat cancer: Flexible endoscopy of larynx. If any abnormalities are observed, it is followed by examination of taking small tissue sample (biopsy).
  4. Screening for esophageal cancer: Upper endoscopy or endoscopic screening test. It is used to screen and diagnose Barrett’s esophagus and esophageal cancer
  5. Relevant genetic tests
  6. Imaging tests such as computerized tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) scans.

Dizziness or lightheadedness, or unsteadiness

Nausea

Vomiting

Headache

FAQ's :

Individuals with inherited gene defects (alterations/mutations) have a high risk of throat cancer, such as hypopharynx cancer.

Nutrient and vitamin deficiency can decrease a person’s immunity and makes them susceptible for getting throat cancer.

It is better to avoid acidic fruits (such as oranges, grapefruits, lemons) or acidic fruit juices. It is recommended not to eat spicy foods, or anything with rough textures, such as toast or crackers. It is best to gargle and rinse your mouth every 4 to 6 hours.

Genetics do seem to play a role in development of GERD or GERD associated disorders like Barrett’s esophagus. Studies reveal that there is a 31% possibility of the heritability of the disease. Family history of esophageal cancer is the major contributing factor.

RHBDF2 gene is the most commonly associated gene with esophageal cancer. Individuals with this gene are at more risk of developing squamous cell type of esophageal cancer.

References:

  1. Throat cancer. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/throat-cancer/symptoms-causes/syc-20366462 Accessed on 04-06-2022
  1. Throat Cancer Causes & Risk Factors. Memorial Sloan Kettering Cancer Center. https://www.mskcc.org/cancer-care/types/throat/throat-cancer-risk-factors-prevention Accessed on 04-06-2022
  1. Esophageal Cancer. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/esophageal-cancer/symptoms-causes/syc-20356084 Accessed on 04-06-2022
  1. Esophageal Cancer Risk Factors. American Cancer Society. https://www.cancer.org/cancer/esophagus-cancer/causes-risks-prevention/risk-factors.html Accessed on 04-06-2022
  1. Esophageal Cancer: Risk Factors. Cancer. Net. https://www.cancer.net/cancer-types/esophageal-cancer/risk-factors Accessed on 04-06-2022
  1. Malacards Human Disease Database. https://www.malacards.org/card/hypopharynx_cancer Accessed on 04-06-2022
  1. Osephageal Cancer. OMIM. https://www.omim.org/entry/133239 Accessed on 04-06-2022

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