Parfitt Jeremy R, Miladinovic Zoran, Driman David K
Department of Pathology, London Health Sciences Centre, University of Western Ontario, London, Ontario N6A 5A5.
Can J Gastroenterol. 2006 Apr;20(4):271-6. doi: 10.1155/2006/175751.
The increasing incidence of esophageal and proximal gastric (cardia) adenocarcinoma and the decreasing incidence of distal gastric (antropyloric) adenocarcinoma has been documented in several populations. The aim of the present study was to examine incidence trends of these neoplasms in Ontario, Canada's most populous province, over a 39-year period.
Analyses were based on data obtained from the Ontario Cancer Registry of Cancer Care Ontario. Number of cases and rates per 100,000 age-adjusted to the 1996 Canadian standard, were obtained for all esophageal and gastric carcinoma cases reported between 1964 and 2002. Rates were grouped into five-year periods to analyze trends over the 39-year period. Point and 95% CI estimates of average annual percentage change in incidence rates were calculated with a log-linear regression model.
The incidence of adenocarcinoma of the distal esophagus increased in men and women (average annual increase of 9.5% in men; 4.3% in women). The incidence of adenocarcinoma of the cardia increased in men and women (average annual increase of 7.3% in men; 5.8% in women). The incidence of antropyloric adenocarcinoma increased in men and women (average annual increase of 4.4% in men; 5.3% in women). The incidence of esophageal squamous cell carcinoma remained stable.
There has been a significant increase in the incidence of adenocarcinoma around the gastroesophageal junction in men over the 39-year study period. The increase in incidence of distal gastric adenocarcinoma is unexpected and may relate to a reclassification phenomenon, immigration trends in Ontario and a rising incidence of diffuse/signet ring cell adenocarcinoma.
在多个人群中已证实食管和近端胃（贲门）腺癌的发病率上升，而远端胃（胃窦）腺癌的发病率下降。本研究的目的是调查在加拿大人口最多的安大略省，这几种肿瘤在39年期间的发病趋势。
分析基于从安大略癌症护理中心的安大略癌症登记处获得的数据。获取了1964年至2002年期间报告的所有食管癌和胃癌病例的病例数以及按1996年加拿大标准进行年龄调整后的每10万人发病率。发病率按五年分组，以分析39年期间的趋势。采用对数线性回归模型计算发病率平均年变化百分比的点估计值和95%置信区间估计值。
远端食管癌的发病率在男性和女性中均有所上升（男性平均年增长率为9.5%；女性为4.3%）。贲门腺癌的发病率在男性和女性中均有所上升（男性平均年增长率为7.3%；女性为5.8%）。胃窦腺癌的发病率在男性和女性中均有所上升（男性平均年增长率为4.4%；女性为5.3%）。食管鳞状细胞癌的发病率保持稳定。
在39年的研究期间，男性胃食管交界周围腺癌的发病率显著上升。远端胃腺癌发病率的上升出乎意料，可能与重新分类现象、安大略省的移民趋势以及弥漫性/印戒细胞腺癌发病率的上升有关。
