THURSDAY, Nov. 10 (HealthDay News) -- The incidence of a deadly form of esophagus cancer associated with gastroesophageal reflux disease (GERD) is rising at an alarming rate, experts say.

Some 90 percent of people who develop adenocarcinoma of the esophagus will be dead within five years and, currently, there are few effective prevention, screening or treatment methods available.

Those are the major messages of a review article appearing in the November/December issue of CA: A Cancer Journal for Clinicians, published by the American Cancer Society.

"Of all the cancers that are increasing, this one is the most rapidly increasing. It way outpaces melanoma and prostate cancer," said Dr. Rhonda F. Souza, co-author of the report and associate professor of medicine at the Dallas VA Medical Center and University of Texas Southwestern Medical School.

"What they say is absolutely true," added Dr. Jay Brooks, chairman of hematology/oncology at the Ochsner Clinic Foundation in Baton Rouge. "The incidence is increasing dramatically in this country, and we don't have a clear indication for it."

The incidence of esophageal adenocarcinomas has soared 600 percent since the 1970s. By contrast, the incidence of gastric cancers has been on the wane in Western countries for the last 50 years.

Despite the startling increase, the actual number of adenocarcinomas of the esophagus is not huge: 7,000 to 8,000 new cases per year in the United States. By contrast, 145,000 people are expected to develop colon cancer in 2005, according to the American Cancer Society.

"Even though it's increased, it's still not as prevalent as colon cancer," Souza said.

Unlike colon cancer, however, there are no really good screening techniques for esophageal adenocarcinomas. This despite the fact that the major risk factors are known to be GERD and Barrett's esophagus, a precancerous condition in which the esophagus changes so that some of its lining is replaced by tissue similar to that normally found in the intestine.

Each year, about one half of 1 percent of people with Barrett's, or one in 200, will go on to develop adenocarcinoma of the esophagus.

Obesity may also play a role in the disease. "No one is really sure," Souza said. "In the West, body mass index is increasing, and it's thought that by becoming obese, people are more predisposed to getting heartburn."

The problem lies in identifying those people most likely to develop this type of cancer.

"We don't know who's walking around out there with Barrett's that we need to watch," Souza said.

But there may be some ways to narrow it down.

"People who get this cancer are those who have GERD and, in the U.S., probably 60 million people have reflux and about 20 percent of those have reflux on a weekly basis, and those are the ones who'd be most at risk to get this cancer," Souza said. "If you have chronic reflux, you need to pay attention, and if you have reflux and you have trouble swallowing, weight loss or bleeding, you should see a doctor. Those are alarm or early-warning signs."

There is some evidence that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) may help prevent esophagus cancer from developing in patients with Barrett's esophagus. Souza and her co-author, however, are not convinced the benefits outweigh the risks.

For those at high risk -- a white male aged 65 to 74 with longstanding heartburn, for example, Souza recommends seeing a physician and getting an endoscopy even in the absence of any alarm symptoms and, hopefully, before a tumor has developed.

"Endoscopically, we can see precursor lesions," Souza pointed out. If any abnormalities are found, patients can then enroll in a more formal surveillance program.

"Your chances are better because it's at an earlier stage," she added.

"Probably the single most important thing we can do to reduce this is lose weight, because increased abdominal weight tends to hold back the normal flow of food, and that's one thing that can create GERD," Brooks added. "The second thing is, if people have reflux symptoms, they really do need to see their doctors because, many times, an upper endoscopy can detect things very quickly. Then you can treat it aggressively to try to prevent the progression. It's not 100 percent, but it's the best that we have at this point."

More information

For more on esophagus cancer, head to the American Cancer Society.