Which of the following is considered a significant risk factor for oesophageal adenocarcinoma, but not for oesophageal squamous cell carcinoma?

Options:
explanation: This is the correct answer. Oesophageal cancer can be divided into squamous cell carcinoma (SCC) and adenocarcinoma. The lower 1/3rd of the oesophagus, which is lined by simple columnar epithelium, and the gastroesophageal junction is where an oesophageal adenocarcinoma is most likely to occur while the upper 2/3rd of the oesophagus, which is lined by non-keratinized stratified squamous epithelium, is the most likely region for oesophageal SCC to occur. The gastroesophageal (squamocolumnar) junction, known as the "Z line", demarcates the transition from non-keratinized stratified squamous epithelium to simple columnar epithelium of the gastric cardia. This is also the landmark for Barrett's oesophagus in oesophagogastroduodenoscopy and on biopsy where the line will appear irregular due to intestinal metaplasia. Gastro-oesophageal reflux disease (GORD) is a risk factor for the development of Barrett's oesophagus, which in turn is a risk of oesophageal adenocarcinoma. In contrast, risk factors such as a history of smoking, excess alcohol consumption, and a poor diet (low in fruits and vegetables) account for 90% of oesophageal SCC. Other predisposing factors include anatomical abnormalities such as achalasia, caustic stricture, oesophageal webs (Plummer-Vinson syndrome), history of gastrectomy, atrophic gastritis, and so forth.
name: Gastro-oesophageal reflux disease
label: a
answer: yes
explanation: This is not the correct answer. Caustic strictures in the oesophagus arise following accidental or intentional ingestion of a corrosive substance, and this can pre-dispose to malignant strictures and is a risk factor for oesophageal squamous cell carcinoma (SCC). Oesophageal cancer can be divided into squamous cell carcinoma (SCC) and adenocarcinoma. The lower 1/3rd of the oesophagus, which is lined by simple columnar epithelium, and the gastroesophageal junction is where an oesophageal adenocarcinoma is most likely to occur while the upper 2/3rd of the oesophagus, which is lined by non-keratinized stratified squamous epithelium, is the most likely region for oesophageal SCC to occur. 80% of oesophageal adenocarcinomas are attributed to Barrett's oesophagus. This is most commonly associated with gastro-oesophageal reflux disease, but can also be seen in other conditions that increase oesophageal acid exposure and predispose to intestinal metaplasia such as Zollinger-Ellison syndrome or use of lower oesophageal sphincter relaxing drugs/ procedures. Risk factors such as a history of smoking, excess alcohol consumption, and a poor diet (low in fruits and vegetables) account for 90% of oesophageal SCC. Other predisposing factors include anatomical abnormalities such as achalasia, caustic stricture, oesophageal webs (Plummer-Vinson syndrome), history of gastrectomy, atrophic gastritis, and so forth.
name: Caustic oesophageal stricture
label: d
answer: no
explanation: This is not the correct answer. NSAIDs reduce inflammation and pain and are not associated with increasing risk of oesophageal adenocarcinoma. Oesophageal cancer can be divided into squamous cell carcinoma (SCC) and adenocarcinoma. The lower 1/3rd of the oesophagus, which is lined by simple columnar epithelium, and the gastroesophageal junction is where an oesophageal adenocarcinoma is most likely to occur while the upper 2/3rd of the oesophagus, which is lined by non-keratinized stratified squamous epithelium, is the most likely region for oesophageal SCC to occur. 80% of oesophageal adenocarcinomas are attributed to Barrett's oesophagus. This is most commonly associated with gastro-oesophageal reflux disease, but can also be seen in other conditions that increase oesophageal acid exposure and predispose to intestinal metaplasia such as Zollinger-Ellison syndrome or use of lower oesophageal sphincter relaxing drugs/ procedures. Risk factors such as a history of smoking, excess alcohol consumption, and a poor diet (low in fruits and vegetables) account for 90% of oesophageal SCC. Other predisposing factors include anatomical abnormalities such as achalasia, caustic stricture, oesophageal webs (Plummer-Vinson syndrome), history of gastrectomy, atrophic gastritis, and so forth.
name: Regular nonsteroidal anti-inflammatory drugs (NSAIDs) use
label: c
answer: no
explanation: This is not the correct answer. Plummer-Vinson syndrome is a classic triad of iron deficiency anaemia, dysphagia and oesophageal webs. Anatomical abnormalities such as achalasia, caustic stricture, oesophageal webs (Plummer-Vinson syndrome), history of gastrectomy, atrophic gastritis, and so forth are risk factors for oesophageal SCC, not adenocarcinoma. However, 90% of the cases of oesophageal SCC are accounted for by a history of smoking, excess alcohol consumption, and a poor diet (low in fruits and vegetables). On the other hand, 80% of oesophageal adenocarcinomas are attributed to Barrett's oesophagus. This is most commonly associated with gastro-oesophageal reflux disease, but can also be seen in other conditions that increase oesophageal acid exposure and predispose to intestinal metaplasia such as Zollinger-Ellison syndrome or use of lower oesophageal sphincter relaxing drugs/ procedures.
name: Plummer-Vinson syndrome
label: e
answer: no
explanation: This is not the correct answer. Alcohol consumption has not been associated with oesophageal adenocarcinoma. Oesophageal cancer can be divided into squamous cell carcinoma (SCC) and adenocarcinoma. The lower 1/3rd of the oesophagus, which is lined by simple columnar epithelium, and the gastroesophageal junction is where an oesophageal adenocarcinoma is most likely to occur while the upper 2/3rd of the oesophagus, which is lined by non-keratinized stratified squamous epithelium, is the most likely region for oesophageal SCC to occur. 80% of oesophageal adenocarcinomas are attributed to Barrett's oesophagus. This is most commonly associated with gastro-oesophageal reflux disease, but can also be seen in other conditions that increase oesophageal acid exposure and predispose to intestinal metaplasia such as Zollinger-Ellison syndrome or use of lower oesophageal sphincter relaxing drugs/ procedures. Risk factors such as a history of smoking, excess alcohol consumption, and a poor diet (low in fruits and vegetables) account for 90% of oesophageal SCC. Other predisposing factors include anatomical abnormalities such as achalasia, caustic stricture, oesophageal webs (Plummer-Vinson syndrome), history of gastrectomy, atrophic gastritis, and so forth.
name: Alcohol consumption
label: b
answer: no

Correct answer: a