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ABOUT THE CONSORTIUM

Introduction

The International Esophageal Squamous Cell Carcinoma Consortium (IESC3) was created to address detailed aspects of the epidemiology of esophageal squamous cell carcinoma (ESCC). IESC3 represents a tool toward a more complete understanding of the causes and mechanisms of ESCC, with the goal of its prevention.

In 2022, there was an estimated 511,054 new cases of esophageal cancer (EC) and 445,391 deaths from the disease globally. There are two histologic types of EC: esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). ESCC is the most common type globally. It is an aggressive condition that predominantly affects the upper and middle parts of the organ. Its incidence is higher in low- and middle-income countries—especially in Eastern Asia, and Eastern and Southern Africa—than in high-income countries, where EAC is the predominant type.

Differences in the distribution of the two types of EC have led to the investigation of specific risk factors that make people more likely to develop this type of cancer. Studies have shown that a diet low in fruits and vegetables, intake of hot beverages, tobacco smoking, alcohol drinking, and low socioeconomic status are the main risk factors of ESCC while gastroesophageal reflux disease (GERD), Barrett’s esophagus (a preneoplastic condition), and overweight/obesity are the main risk factors of EAC. Whereas BEACON, an international consortium of epidemiology of EAC was established in 2005 ( https://www.esocan.org/beacon  ), a similar initiative was not available for ESCC. Thus, the IESC3 was launched in May 2024 to address this important gap.

IESC3 represent a tool toward a more complete understanding of the causes and mechanisms of ESCC, with the goal of its prevention.

IESC3 Research Aims

To examine the detailed role of environmental factors e.g., specific dietary factors, occupational and environmental exposure, physical activity, and socioeconomic status, as well as medical factors, in the etiology of ESCC.

To identify novel risk factors of ESCC, which have eluded epidemiologic investigation because of low power or misclassification.
To examine the role of modifiable risk factors on mortality, survival, recurrence and secondary primary tumors following ESCC.
To explore detailed aspects of the genetic determinants of ESCC and their interaction with modifiable risk factors.
To explain the difference in disease occurrence between different geographical patterns, races, genders and ages.

To provide the infrastructure for discovery of novel ESCC biomarkers.

To examine the associations between risk factors and clinical characteristics of the disease (e.g., topography, stage, grade).

To assess the effect of screening methods and awareness programs on ESCC prevention and outcome management.

To validate the effect of different treatment guidelines and approaches on mortality, survival, and quality of life in cases.

To apply novel epidemiological and statistical methods (e.g., machine learning, personalized risk assessment).