Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
Gut. 2015 Mar;64(3):381-7. doi: 10.1136/gutjnl-2014-308124. Epub 2014 Oct 15.
The two major histological types of oesophageal cancer--adenocarcinoma (AC) and squamous cell carcinoma (SCC)--are known to differ greatly in terms of risk factors and epidemiology. To date, global incidence estimates for individual subtypes are still lacking. This study for the first time quantified the global burden of oesophageal cancer by histological subtype.
Where available, data from Cancer Incidence in Five Continents Vol. X (CI5X) were used to compute, age-specific, sex-specific and country-specific proportions of AC and SCC. Nine regional averages were computed for countries without CI5X data. The proportions were then applied to all oesophageal cancer cases from GLOBOCAN 2012 and age-standardised incidence rates calculated for both histological types.
Worldwide, an estimated 398,000 SCCs and 52,000 ACs of the oesophagus occurred in 2012, translating to incidence rates of 5.2 and 0.7 per 100,000, respectively. Although SCCs were most common in South-Eastern and Central Asia (79% of the total global SCC cases), the highest burden of AC was found in Northern and Western Europe, Northern America and Oceania (46% of the total global AC cases). Men had substantially higher incidence than women, especially in the case of AC (male to female ratio AC: 4.4; SCC: 2.7).
These first global estimates of oesophageal cancer incidence by histology suggested a high concentration of AC in high-income countries with men being at much greater risk. This quantification of incidence will aid health policy makers to plan appropriate cancer control measures in the future.
食管的两种主要组织学类型——腺癌(AC)和鳞状细胞癌(SCC)——在危险因素和流行病学方面存在显著差异。迄今为止,仍然缺乏对各亚组的全球发病率估计。本研究首次对食管的组织学亚型的全球负担进行了量化。
在有可用数据的情况下,使用《五大洲癌症发病率》第 X 卷(CI5X)的数据来计算 AC 和 SCC 的年龄、性别和国家特异性比例。对于没有 CI5X 数据的国家,计算了 9 个地区平均值。然后将这些比例应用于 2012 年 GLOBOCAN 所有的食管癌症病例,并计算了两种组织学类型的年龄标准化发病率。
2012 年,全球估计有 398,000 例 SCC 和 52,000 例 AC 食管癌,发病率分别为 5.2 和 0.7/100,000。尽管 SCC 在东南亚和中亚最为常见(占全球 SCC 病例总数的 79%),但 AC 的负担最重的地区是北欧和西欧、北美和大洋洲(占全球 AC 病例总数的 46%)。男性的发病率明显高于女性,尤其是在 AC 中(男性与女性的比例 AC:4.4;SCC:2.7)。
这些首次按组织学对食管癌症发病率的全球估计表明,高收入国家的 AC 高度集中,男性的风险更大。这种发病率的量化将有助于卫生政策制定者在未来制定适当的癌症控制措施。