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要旨●欧米の食道腺癌の頻度は,1970年代後半から急増し,1990年代後半に扁平上皮癌を逆転,現在では腺癌が約6割を占めている.しかし国や地域によって増加の程度が異なり,その背景には人種や生活様式などによる差が関与していると思われた.本邦の食道腺癌の頻度は2%以下であったが,5.4〜6.4%まで上昇してきている.その背景には,食生活の変化により肥満が増え逆流性食道炎が増加したこと,H. pyloriの感染率の低下などが挙げられる.しかし,欧米に比べて肥満の程度が軽く,逆流性食道炎が少ない本邦には,好発人種である白人もおらず,今後欧米ほどの急上昇はみられないと考えている.
Over the past decades, the incidence of esophageal adenocarcinoma has rapidly increased in the US and Europe. In Japan, the incidence of esophageal adenocarcinoma was approximately 2.0% of the population until 1999, and this increased to 6.4% by 2013. Several investigations have identified white race, male sex, GERD, obesity, and the absence of Helicobacter pylori status as risk factors for esophageal adenocarcinoma. It is recognized that the prevalence of obesity and the frequency of GERD are much lower in the Japanese population compared with those in the US and Europe. Therefore, the incidence of Barrett's adenocarcinoma in Japan is unlikely to increase as dramatically as that in the Western countries.
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