Trivers Katrina F, Sabatino Susan A, Stewart Sherri L
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
Int J Cancer. 2008 Sep 15;123(6):1422-8. doi: 10.1002/ijc.23691.
Esophageal adenocarcinoma rates may be increasing, whereas, squamous cell carcinoma rates appear to be decreasing in the United States. Previous population-based research on esophageal cancer has only covered up to 68% of the country. Additional, updated research on a larger percentage of the country is needed to describe racial, ethnic and regional trends in histologic subtypes of esophageal cancer. Invasive esophageal cancer cases diagnosed between 1998 and 2003 (n = 65,926), collected by the National Program of Cancer Registries or the Surveillance, Epidemiology, and End Results program, were included. These data cover 83% of the US population. Esophageal squamous cell carcinoma incidence fell by 3.6%/year, whereas esophageal adenocarcinoma increased by 2.1%/year. Squamous cell carcinoma rates decreased among both sexes in most racial or ethnic groups, whereas adenocarcinoma rates increased primarily among white or non-Hispanic men. Except for white or non-Hispanic men, squamous cell carcinoma rates were similar to, or greater than, adenocarcinoma rates for men and women of all other races and ethnicities. The largest decrease in squamous cell carcinoma rates occurred in the West census region, which also exhibited no increase in adenocarcinoma rates. The rate of regional and distant-staged adenocarcinomas increased, while rates for local-staged adenocarcinoma remained stable. This is the first article to characterize esophageal cancer trends using data covering the majority of the US. Substantial racial, ethnic and regional variation in esophageal cancer is present in the US. Our work may inform interventions related to tobacco and alcohol use, and overweight/obesity prevention, and provide avenues for further research.
在美国，食管腺癌的发病率可能在上升，而鳞状细胞癌的发病率似乎在下降。以往基于人群的食管癌研究仅覆盖了该国68%的地区。需要对该国更大比例的地区进行更多更新的研究，以描述食管癌组织学亚型的种族、民族和地区趋势。纳入了由国家癌症登记计划或监测、流行病学和最终结果计划收集的1998年至2003年期间诊断的侵袭性食管癌病例（n = 65,926）。这些数据覆盖了美国83%的人口。食管鳞状细胞癌的发病率每年下降3.6%，而食管腺癌每年增加2.1%。在大多数种族或族裔群体中，两性的鳞状细胞癌发病率均下降，而腺癌发病率主要在白人或非西班牙裔男性中上升。除白人或非西班牙裔男性外，所有其他种族和族裔的男性和女性的鳞状细胞癌发病率与腺癌发病率相似或更高。鳞状细胞癌发病率下降幅度最大的是西部人口普查地区，该地区的腺癌发病率也没有上升。区域和远处分期腺癌的发病率上升，而局部分期腺癌的发病率保持稳定。这是第一篇利用覆盖美国大部分地区的数据来描述食管癌趋势的文章。美国食管癌存在显著的种族、民族和地区差异。我们的工作可能为与烟草和酒精使用以及超重/肥胖预防相关的干预措施提供信息，并为进一步研究提供途径。
