Demographic variations in the rising incidence of esophageal adenocarcinoma in white males

Abstract

BACKGROUND The rise in adenocarcinoma (AC) of the esophagus has been reported in several papers. However, the results are only comparable to a limited extent, because they are based on differing periods and different computational methods. The purpose of the current investigation was to collect the available data and to analyze them in a unified manner. METHODS The authors requested data on the incidence of AC of the esophagus for each year since 1960 from 43 tumor registries in North America, Europe, and Australia. The data from 22 centers were used. The trend was calculated by fitting the data to an exponential growth model. RESULTS The incidence of AC of the esophagus in white males is rising in most countries. The highest values of the estimated incidence rate in the year 2000 were found in Great Britain (5.0– 8.7 cases per 100,000 population) and in Australia (4.8 cases per 100,000 population) followed by The Netherlands (4.4 cases per 100,000 population), the United States (3.7 cases per 100,000 population), and Denmark (2.8 cases per 100,000 population). Low rates (< 1.0 cases per 100,000 population) were found in Eastern Europe. The largest changes in incidence were reported in the Southern European countries, with an estimate of the average increase over six registries of 30% per year; in Australia, with an average increase of 23.5% per year; and in the United States, with an average increase of 20.6% per year. The rates of increase ranged from 8.7% to 17.5% on average in Northern Europe, Central Europe, and the United Kingdom. In Eastern Europe, at most, there was a minor rise in incidence. CONCLUSIONS In the Western industrialized nations, the analyzed data show that the incidence of AC of the esophagus has been rising rapidly in the last 20 years. The only exceptions to date are the countries of Eastern Europe. Cancer 2001;92:549–55. © 2001 American Cancer Society.

Epidemiology and Clinical Presentation in Esophageal Cancer

“…Since the mid 1990s its incidence has exceeded that for SCC [14,15,16]. The rise in incidence is most marked in the white male population, reaching about 5/100 000 for the white males in North America and 8-12/100 000 for white males in the highest incidence countries of Australia and the UK [7,13,17,18,19,20,21,22]. This represents an increase of about 400-800% from the 1970s and is about four times greater than the incidence for black males in the United States.…”

DNA copy number alterations correlate with survival of esophageal adenocarcinoma patients

“…Over the past few decades, although the incidence of the former has remained stable, the incidence of esophageal adenocarcinoma has risen in the western world and Asia. [1][2][3] Despite recent advances in therapies, including surgery, chemotherapy, radiotherapy, immunotherapy, and combinations thereof, the prognosis for patients with esophageal adenocarcinoma remains poor. Tumor recurrence frequently occurs within 2 years, although some patients survive long after surgery; a considerable variability and heterogeneity within the tumor stages exists, but none of the staging criteria accurately predicts the prognosis for an individual patient.…”

Differential SPARC mRNA expression in Barrett's oesophagus

“…This condition predisposes to the development of oesophageal adenocarcinoma, the incidence of which has been increasing rapidly in the United States and other Western countries (Bollschweiler et al, 2001). Oesophageal adenocarcinoma usually presents at an advanced stage and undergoes a rapidly fatal course, with 5-year survival rates of approximately 25 -30% (Holscher et al, 1995).…”