Cancer Of The Esophagus

The book deals with the normal structure, functioning and biochemistry of the esophagus and with the histological and genetic changes accompanying the development of esophageal cancer in humans and animals. The book is unique in treating the etiology of the disease. Factors implicated in causing esophageal cancer are described in relation to its very dramatic epidemiology. Dietary deficiencies and consumption of foods contaminated by Fusaria mycotoxins are discussed in connection with the extremely high incidence of the disease in certain sharply-demarcated regions in China and South Africa, and alcohol and tobacco use in relation to the epidemiology in Europe and the United States. Other hazards include opium in Iran, betel nut in Asia and bracken in Japan. The nitrosamines, the sole group of chemicals known to be very potent esophageal carcinogens in animal experiments, are described especially in terms of the widespread human exposure. It is proposed that these chemicals are responsible for initiation of the disease but that promotion by the secondary risk factors is generally essential for symptomatic cancer to develop. The recent perturbing increase in adenocarcinoma is considered.