Barrios Enrique, Sierra Monica S, Musetti Carina, Forman David
Registro Nacional de Cáncer, CHLCC, Uruguay; Dept. of Quantitative Methods, Faculty of Medicine, Montevideo, Uruguay.
International Agency for Research on Cancer, Section of Cancer Surveillance, Lyon, France.
Cancer Epidemiol. 2016 Sep;44 Suppl 1:S53-S61. doi: 10.1016/j.canep.2016.03.013.
Oesophageal cancer shows marked geographic variations and is one of the leading causes of cancer death worldwide. We described the burden of this malignancy in Central and South America.
Regional and national level incidence data were obtained from 48 population-based cancer registries in 13 countries. Mortality data were obtained from the WHO mortality database. Incidence of oesophageal cancer by histological subtype were available from high-quality population-based cancer registries.
Males had higher incidence and mortality rates than females (male-to-female ratios: 2-6:1 and 2-5:1). In 2003-2007, the highest rates were in Brazil, Uruguay, Argentina and Chile. Mortality rates followed the incidence patterns. Incidence of oesophageal squamous cell carcinoma (SCC) was higher than adenocarcinoma (AC), except in females from Cuenca (Ecuador). SCC and AC incidence were higher in males than females, except in the Region of Antofagasta and Valdivia (Chile), Manizales (Colombia) and Cuenca (Ecuador). Incidence and mortality rates tended to decline in Argentina, Chile, Brazil (incidence) and Costa Rica from 1997 to 2008.
The geographic variation and sex disparity in oesophageal cancer across Central and South America may reflect differences in the prevalence of tobacco smoking and alcohol consumption which highlights the need to implement and/or strengthen tobacco and alcohol control policies. Maté consumption, obesity, diet and Helicobacter pylori infection may also explain the variation in oesophageal cancer rates but these relationships should be evaluated. Continuous monitoring of oesophageal cancer rates is necessary to provide the basis for cancer prevention and control in the region.
食管癌呈现出显著的地域差异，是全球癌症死亡的主要原因之一。我们描述了中南美洲这种恶性肿瘤的负担情况。
区域和国家层面的发病率数据来自13个国家的48个基于人群的癌症登记处。死亡率数据来自世界卫生组织死亡率数据库。食管癌组织学亚型的发病率可从高质量的基于人群的癌症登记处获取。
男性的发病率和死亡率高于女性（男女比例分别为2 - 6:1和2 - 5:1）。2003 - 2007年，发病率最高的是巴西、乌拉圭、阿根廷和智利。死亡率遵循发病率模式。食管鳞状细胞癌（SCC）的发病率高于腺癌（AC），昆卡（厄瓜多尔）的女性除外。除了阿塔卡马地区和瓦尔迪维亚（智利）、马尼萨莱斯（哥伦比亚）和昆卡（厄瓜多尔），SCC和AC的发病率男性高于女性。1997年至2008年，阿根廷、智利、巴西（发病率）和哥斯达黎加的发病率和死亡率呈下降趋势。
中南美洲食管癌的地理差异和性别差异可能反映了吸烟和饮酒流行率的差异，这突出了实施和/或加强烟草和酒精控制政策的必要性。马黛茶消费、肥胖、饮食和幽门螺杆菌感染也可能解释食管癌发病率的差异，但这些关系需要评估。持续监测食管癌发病率对于该地区癌症预防和控制提供依据是必要的。
