Cancer Research UK scientists show that while inherited faulty genes can increase the risk of Barrett’s Oesophagus – a condition linked to acid reflux – it may be  lifestyle factors such as smoking and obesity that cause it to develop into oesophageal cancer – according to a major study published in Nature Genetics.

Cancer Research UK scientists, as part of a consortium, compared the genetic make-up of patients with oesophageal cancer (adenocarcinoma) and patients with Barrett’s Oesophagus with healthy patients by studying thousands of tissue samples from several large studies.

Barrett’s is treatable but changes in the oesophagus can sometimes develop into cancer.

The team discovered an overlap between the genetic fingerprint of Barrett’s Oesophagus and oesophageal cancer. One gene called FOXP1 in particular was found to be faulty in both conditions.

FOXP1 controls oesophageal development and the research suggests that faulty versions of this gene trigger changes which cause Barrett’s Oesophagus. Most patients with Barrett’s Oesophagus can be successfully treated but in some cases the disease can develop into cancer.

Professor Rebecca Fitzgerald, Cancer Research UK and MRC scientist at the University of Cambridge and one of the study authors, said: “This research suggests the reason some patients with Barrett’s Oesophagus go on to develop oesophageal cancer isn’t purely genetic but may also be related to lifestyle or environmental factors which can be managed.”

“Much more research is needed to confirm these very early findings and this study doesn’t address those rare cases of inherited oesophageal cancer which are caused by genetic faults and not by lifestyle.”

There are two main types of oesophageal cancer, adenocarcinoma and squamous cell carcinomas. Obesity, tobacco and long term acid reflux increase the risk of adenocarcinoma, while tobacco and alcohol are the most common risk factors for squamous cell carcinoma.

Oesophageal cancer is the ninth most common cancer in the UK with around 8,500 new cases diagnosed each year and around 7,600 deaths. It is not known how many cases of cancer are caused by genetic faults –but most cases of the disease are believed to be caused by a combination of lifestyle and genetic changes.

Oesophageal cancer rates in men have risen by almost 60 per cent over the last 30 years. In women the rates increased by 10 per cent. Mr Tim Underwood, an oesophageal surgeon and researcher at the University of Southampton, said:  “These findings show just how important leading a healthy lifestyle is in reducing your risk of oesophageal cancer. But there’s still so much more we need to understand about the disease. One of the most important research projects is unravelling the genetic code of oesophageal cancer. British scientists, funded by Cancer Research UK’s Catalyst Club, are working on this as part of the International Cancer Genome Consortium (ICGC).

“To raise the money to fund this vital research, I’m going to be running the New York Marathon for the Catalyst Club project in November. My fellow team of runners and I have pledged to raise £100,000.”

Dr Julie Sharp, Cancer Research UK’s senior science information manager, said: “Sadly survival for oesophageal cancer remains low but studies like this help paint a picture of how the disease develops –so we can find new ways to stop it in its tracks.”

“We know that lifestyle plays an important role in this disease – by understanding more about the role of both genes and lifestyle we can find better ways to prevent oesophageal cancer and save more lives in the future.”

Source: CRUK