More than 450.000 people are diagnosed with esophageal cancer (EC) each year worldwide and ~400.000 die annually from the disease. The high mortality rate is attributed to the late detection of the disease, largely due to insufficient detection methods today. Besides loss of life, treating late disease incurs costs in the range of $80,000-250,000 per patient lifetime making esophageal cancer among the most expensive diseases to treat in oncology today. Risk factors, including obesity, chronic gastroesophageal reflux disease (GERD) and Barret’s esophagus, implicate diagnostically a much larger population. It is estimated that at least 100 million people suffer of GERD in Western Countries and that ~10 million people in Western countries live with Barrett’s esophagus. Alarmingly, due to an aging and more overweight population the incidence rates of GERD, Barrett’s esophagus and EC are increasing.

Today, EC detection and diagnosis is typically based on white-light endoscopy (WLE), i.e. the visual inspection of the esophagus lumen through an optical system (endoscope) and subsequent pathological analysis of biopsied samples. Human vision however is insensitive to detecting early disease (dysplasia / sub-surface lesions) and lacks specificity and staging ability compromising disease prognosis. Due to WLE limitations, random biopsies may be prescribed to improve the chances of detecting early disease and tumor staging. Random tissue sampling is nevertheless sub-optimal and it may miss EC. Therefore, EC is often detected late in the course of development, which decreases the five year survival rate by more than 80% compared to early detection of the disease.

Thus, a novel tool for early detection of EC is urgently needed.

read more...