Cancer-Focused TeamsOesophageal Cancer Team (ECA)

Starting date: June 2022

Work Programme

The overall aim of the Oesophageal Cancer Team (ECA) is to enhance research on the prevention and early detection of oesophageal cancer worldwide through a cross-Agency research approach, which aims to benefit from the sharing of data and resources, networks, and multidisciplinary angles spanning from the mechanistic level to the population level. Many inter-Branch collaborations on oesophageal cancer already exist. ECA brings these together and convenes meetings to enhance existing collaborations and identify new opportunities. The main contributors to ECA are the Genomic Epidemiology Branch (GEM), the Epigenomics and Mechanisms Branch (EGM), the Cancer Surveillance Branch (CSU), and the Environment and Lifestyle Epidemiology Branch (ENV). CSU leads on descriptive epidemiology. ENV leads many of the African studies, including a large fieldwork component. GEM and EGM lead on their respective expertise in genomics and epigenomics, with stand-alone studies and, where possible, research embedded within ENV and CSU fieldwork studies. Thus, the activities of ECA are:

descriptive epidemiology to understand the incidence patterns and time trends of oesophageal cancer throughout the world (CSU, GEM, and ENV);
identifying novel risk factors for oesophageal cancer in diverse populations using traditional, molecular, and genetic epidemiology (GEM, ENV, and EGM); and
identifying feasible early detection strategies for oesophageal cancer in diverse populations using traditional, molecular, and genetic epidemiology (GEM, ENV, and EGM).

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These activities align with IARC’s objectives to identify the causes of cancer and produce evidence-based science for global cancer control and prevention.

Interplay of descriptive epidemiology with insights from case–control studies

Analysis of oesophageal squamous cell carcinoma (ESCC) anatomical tumour location: an international study of determinants by sex and risk factors for ESCC (CSU, ENV, and GEM)
- Rationale: An excess of upper ESCC tumours has been reported in women in Africa, but this feature has not been studied internationally.

ESCCAPE: Oesophageal squamous cell carcinoma case–control studies in East Africa (https://esccape.iarc.who.int/)

The role of smokeless tobacco use and tobacco smoking in ESCC in East Africa (ENV)
- Rationale: Tobacco is an established risk factor for ESCC, but sex-specific population attributable fractions (PAFs) are not well characterized in Africa.
ESCC risk score in Africa (ENV)
- Rationale: The existing ESCC risk scores were developed in Europe, North America, and Asia, but there are none in Africa.

Epigenomics

Testing DNA methylation/molecular markers of ESCC on minimally invasive biospecimens for early detection (EGM and ENV)
Infections and ESCC (ENV and EGM)

Genomics

ESCC mutational spectrum: investigation of variations by sex and with improved exposure variation

Team Composition

Team Leaders: Dr Valerie McCormack (Deputy Branch Head), Environment and Lifestyle Epidemiology Branch (ENV) and Dr Behnoush Abedi-Ardekani, Genomic Epidemiology Branch (GEM), IARC
Emails: McCormackV@iarc.who.int; AbediB@iarc.who.int

Team members:
Dr Hannah Simba (Postdoctoral Scientist, ENV)
Dr Joachim Schüz (Branch Head, ENV)
Dr Clement Narh (Visiting Scientist, ENV, and University of Health and Allied Sciences, Hohoe, Ghana)
Dr Mahdi Sheikh (Scientist, GEM)
Dr Sergey Senkin (Postdoctoral Scientist, GEM)
Dr Paul Brennan (Branch Head, GEM)
Dr Fazlur Talukdar (Postdoctoral Scientist, EGM)
Dr Zdenko Herceg (Branch Head, EGM)
Dr Tarik Gheit (Scientist, EGM)
Dr Eileen Morgan (Postdoctoral Scientist, CSU)

Key networks: The international team members span many countries, including the Islamic Republic of Iran, Kenya, the United Republic of Tanzania, Malawi, Brazil, and the United Kingdom, and are listed on constituent project websites, including Oesophageal Squamous Cell Carcinoma African Prevention Research (ESCCAPE; https://esccape.iarc.who.int/), working with the African Esophageal Cancer Consortium (AfrECC; https://dceg.cancer.gov/research/cancer-types/esophagus/afrecc) and the Mutographs project (https://www.mutographs.org/).

Key funding: World Cancer Research Fund (WCRF), Cancer Research UK (CRUK), United Kingdom Medical Research Council (MRC)

Key publications

Middleton DRS, Mmbaga BT, Menya D, Dzamalala C, Nyakunga-Maro G, Finch P, et al.; ESCCAPE (2022). Alcohol consumption and oesophageal squamous cell cancer risk in east Africa: findings from the large multicentre ESCCAPE case-control study in Kenya, Tanzania, and Malawi. Lancet Glob Health. 10(2):e236–45. https://doi.org/10.1016/S2214-109X(21)00506-4 PMID:34921758
Moody S, Senkin S, Islam SMA, Wang J, Nasrollahzadeh D, Cortez Cardoso Penha R, et al. (2021). Mutational signatures in esophageal squamous cell carcinoma from eight countries with varying incidence. Nat Genet. 53(11):1553–63. https://doi.org/10.1038/s41588-021-00928-6 PMID:34663923
Talukdar FR, Soares Lima SC, Khoueiry R, Laskar RS, Cuenin C, Sorroche BP, et al. (2021). Genome-wide DNA methylation profiling of esophageal squamous cell carcinoma from global high-incidence regions identifies crucial genes and potential cancer markers. Cancer Res. 81(10):2612–24. https://doi.org/10.1158/0008-5472.CAN-20-3445 PMID:33741694
Arnold M, Morgan E, Bardot A, Rutherford MJ, Ferlay J, Little A, et al. (2021). International variation in oesophageal and gastric cancer survival 2012–2014: differences by histological subtype and stage at diagnosis (an ICBP SURVMARK-2 population-based study). Gut. gutjnl-2021-325266. https://doi.org/10.1136/gutjnl-2021-325266 PMID:34824149
Sheikh M, Poustchi H, Pourshams A, Khoshnia M, Gharavi A, Zahedi M, et al. (2020). Household fuel use and the risk of gastrointestinal cancers: the Golestan Cohort Study. Environ Health Perspect. 128(6):67002. https://doi.org/10.1289/EHP5907 PMID:32609005
McCormack VA, Menya D, Munishi MO, Dzamalala C, Gasmelseed N, Leon Roux M, et al. (2017). Informing etiologic research priorities for squamous cell esophageal cancer in Africa: a review of setting-specific exposures to known and putative risk factors. Int J Cancer. 140(2):259–71. https://doi.org/10.1002/ijc.30292 PMID:27466161