The incidence of adenocarcinoma of the esophagus in the United States increased among both white men and women between 1975 and 2004, according to a study published in the August 12 online issue of the Journal of the National Cancer Institute.
The overall incidence of esophageal cancer has been climbing in white men, holding steady in white women, and decreasing in black men and women. Previous reports suggested that the increase in white men was due to an increase in one type of esophageal cancer called adenocarcinoma.
To get a more detailed picture of the population trends, Linda Morris Brown, Dr.P.H., of the National Cancer Institute and RTI International in Rockville, Md., and colleagues analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database. They identified 22,759 cases of esophageal cancer in white patients diagnosed between 1975 and 2004 and 9,526 of those were adenocarcinoma of the esophagus.
When they grouped the cases into five-year time periods, they found that the total age-adjusted rate for esophageal cancer in white men rose from 5.76 per 100,000 person-years in 1975-1979 to 8.34 per 100,000 person-years in 2000-2004. The increase in esophageal cancer was driven by a 463 percent increase in the rate of adenocarcinoma from 1.01 in the earliest five year period to 5.69 per 100,000 person-years in the last five year period. The overall rate of esophageal cancer remained constant across the study period in white women, at around 2.0 per 100,000 person-years. However, there was a 335 percent increase in the rate of adenocarcinoma during the study period from 0.17 to 0.74 per 100,000 person-years, while the rate of squamous cell carcinoma declined.
"Our data indicate that the increase in adenocarcinoma is real and a growing health problem for both white men and women," the authors write. Recent data indicate that increases in obesity, particularly abdominal obesity, and gastroesophageal reflux disease may account for part of the upward trend in the incidence of ade¬nocarcinoma.
- Brown et al. Incidence of Adenocarcinoma of the Esophagus Among White Americans by Sex, Stage, and Age. JNCI Journal of the National Cancer Institute, 2008; DOI: 10.1093/jnci/djn211
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