Is there any relationship between achalasia and esophageal cancer? According to Healio, a research study found that there does seem to be some level of correlation. In Abstract S388, presented during the ACG Annual Scientific Meeting in October 2022, the presenters note that achalasia was associated with a 5x higher risk for developing esophageal cancer. As a result, the presenter shares, those with achalasia should undergo more endoscopic surveillance measures to ensure early diagnosis and treatment (if needed).
To begin, the researchers sourced data from 1,866 veterans with achalasia, and 7,464 veterans without, from a 21-year period. A majority of patients included in the study (92%) were male. There was a median time of approximately three years between achalasia diagnosis and the development of esophageal cancer. Altogether, researchers found that 17 people with achalasia developed esophageal cancer, or approximately 0.9% of the study group, compared to 15 people without achalasia, or approximately 0.2% of the study group. Therefore, those with achalasia had a 5.4-fold increased risk of developing this cancer.
Additionally, the researchers found that candida esophagitis (an opportunistic Candida infection in the esophagus) correlated with an 18.3-fold increased risk of developing this cancer.
Therefore, researchers believe that more frequent endoscopic surveillance can help to manage patients’ conditions and assess risk.
What is Achalasia?
Achalasia is a rare disorder which occurs when nerves in the esophagus become damaged. This makes it more difficult for the esophagus to squeeze food down or pass into the stomach, as the esophageal sphincter cannot properly relax. Symptoms can include chest pain, dysphagia (impaired ability to swallow), unintended weight loss, persistent coughing, dry eyes and mouth, and a higher risk of pulmonary infections.
What is Esophageal Cancer?
As the name suggests, esophageal cancer begins in esophageal tissue. There are various types of esophageal cancer, such as sarcoma, small cell carcinoma, squamous cell carcinoma, and adenocarcinoma (among others). Knowing the specific subtype is important as it can dictate appropriate treatment measures. Risk factors for esophageal cancer include being male, smoking, consuming alcohol excessively, obesity, gastroesophageal reflux disease (GERD), Barrett’s esophagus, and acid reflux. Symptoms can include hoarseness, bone pain, esophageal obstructions, chronic cough, heartburn, chest pain or pressure, unintended weight loss, and painful or difficult swallowing.