Burgundy Digestive Cancer Registry, INSERM U866, 21079 Dijon Cedex, France.
Dig Liver Dis. 2013 Aug;45(8):625-9. doi: 10.1016/j.dld.2012.12.020. Epub 2013 Feb 28.
Oesophageal adenocarcinoma will soon cease to be a rare form of cancer for people born after 1940. In many Western countries, its incidence has increased more rapidly than other digestive cancers. Incidence started increasing in the Seventies in England and USA, 15 years later in Western Europe and Australia. The cumulative risk between the ages of 15 and 74 is particularly striking in the UK, with a tenfold increase in men and fivefold increase in women in little more than a single generation. Prognosis is poor with a 5-year relative survival rate of less than 10%. The main known risk factors are gastro-oesophageal reflux, obesity (predominantly mediated by intra-abdominal adipose tissues) and smoking. Barrett's oesophagus is a precancerous lesion, however, the risk of degeneration has been overestimated. In population-based studies the annual risk of adenocarcinoma varied between 0.12% and 0.14% and its incidence between 1.2 and 1.4 per 1000 person-years. Only 5% of subjects with Barrett's oesophagus die of oesophageal adenocarcinoma. On the basis of recent epidemiological data, new surveillance strategies should be developed. The purpose of this review is to focus on the epidemiology and risk factors of oesophageal adenocarcinoma.
食管腺癌将很快不再是 1940 年后出生人群的罕见癌症。在许多西方国家，其发病率的增长速度超过了其他消化道癌症。发病率在 20 世纪 70 年代的英国和美国开始上升，15 年后在西欧和澳大利亚上升。在英国，15 至 74 岁人群的累积风险尤其显著，男性的发病率增加了十倍，女性增加了五倍，一代人还不到。预后较差，5 年相对生存率低于 10%。主要的已知危险因素是胃食管反流、肥胖（主要通过腹腔脂肪组织介导）和吸烟。巴雷特食管是一种癌前病变，但退化的风险被高估了。在基于人群的研究中，腺癌的年发病风险在 0.12%至 0.14%之间，其发病率在 1000 人年中为 1.2 至 1.4 例。只有 5%的巴雷特食管患者死于食管腺癌。基于最近的流行病学数据，应制定新的监测策略。本综述的目的是重点关注食管腺癌的流行病学和危险因素。
