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New NICE guideline on Oesophago-Gastric Cancer published

We are happy to announce the publication of the NICE guideline on Oesophago-Gastric Cancer developed by the National Guideline Alliance (NGA).

This guideline focuses on the assessment and management of oesophago-gastric cancer in adults. This includes oesophageal cancer, gastric cancer and cancer occurring at the oesophageal-gastric junction.

Oesophageal cancer is the 13th most common cancer in the UK. In 2011, 8,300 people were diagnosed with the disease. The prevalence of the disease varies significantly around the world, and is more common in men than women. There are two common histological subtypes: squamous cell carcinoma and adenocarcinoma.

Most oesophageal cancers are linked to lifestyle and other risk factors, mainly tobacco smoking, obesity and alcohol.

  • Oesophageal cancer rates have increased by 56% in men and 14% in women since the mid-1970s.
  • Oesophageal cancer is the 6th most common cause of cancer deaths in the UK, accounting for about 5% of all cancer deaths.
  • In 2012, 7,700 people died of oesophageal cancer in the UK, and there were twice as many men than women.
  • Almost half of those who died of oesophageal cancer were aged over 75. The UK mortality rate is the highest in Europe for both men and women.

Gastric cancer is the 11th most common cancer in men and the 15th most common cancer in women in the UK, with 7,100 people diagnosed with the disease in 2011. The incidence has halved in the UK since the late 1980s. It is the 10th most common cause of cancer death in the UK, with 4800 deaths in 2012. Approximately a third of gastric cancers are linked to H. pylori infection, an avoidable risk factor.

Survival rates for both oesophageal and gastric cancers are improving and have tripled in the UK in the last 40 years. However survival rates remain poor, with only 3 in 20 (15%) of people diagnosed with oesophageal cancer and around a fifth (19%) of people diagnosed with stomach cancer in 2010-11 in England and Wales expected to survive their disease for 5 years or more.

Managing people's disease may be complex and needs collaboration and discussion between the person, their family and the medical teams involved.

This guideline covers the information and support that should be offered to people with oesophago-gastric cancer, the organisation of services, including multidisciplinary teams and surgical services, assessment after diagnosis, and treatment options including curative surgery, radiotherapy and chemotherapy.

In addition, the guideline provides guidance on palliative management, nutritional support and follow-up.

"Oesophago-gastric cancer: assessment and management in adults" [NG83] is available on the NICE website from Wednesday 24 January 2018.


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