Patel Nicolas, Benipal Bikramjit
Internal Medicine, New York University School of Medicine, New York, USA.
Internal Medicine, Temple University, Philadelphia, USA.
Cureus. 2018 Dec 10;10(12):e3709. doi: 10.7759/cureus.3709.
Introduction Esophageal cancer is one of the leading causes of death in males in the United States (US). Previous studies have analyzed incidence rates of esophageal cancer in the US using the data from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program. However, given its limited patient population, certain groups and regions in the US are underrepresented. Our study utilizes the United States Cancer Statistics (USCS) database, which combines the SEER database with the Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries (NPCR) to cover all 50 states to examine the incidence of esophageal cancer. Methods The USCS registry was used to obtain data for esophageal cancer from 2001 to 2015. Incidence analysis was stratified based on sex, race, stage, histology, and US regional location/histology. Results The overall incidence of esophageal cancer from 2001-2015 was 4.7 per 100,000 people per year. Overall incidence rates were greatest for each stratification in males, blacks, distant disease, adenocarcinoma, and those in the Midwest with adenocarcinoma. Blacks, compared to other races, had the greatest statistically significant decrease in incidence between 2001-2015 (annual percent change (APC) -4.55). The incidence rate is also increasing the most rapidly in those with adenocarcinoma in the Northeast from 2011 to 2015 (APC 2.16). Conclusion In our study, we were able to determine the incidence of esophageal cancer using data from all 50 states in the US. Our findings of decreasing incidence in blacks and increasing incidence of adenocarcinoma in the Midwest and Northeast help elucidate the at-risk populations. Moreover, our findings help bring to light risk factors that may be contributing to the development of esophageal cancer and how diagnosis and surveillance can be improved based on these risk factors.
引言
食管癌是美国男性主要死因之一。以往研究利用美国国立癌症研究所的监测、流行病学和最终结果(SEER)项目的数据分析了美国食管癌的发病率。然而,鉴于其患者群体有限,美国的某些群体和地区未得到充分体现。我们的研究利用了美国癌症统计(USCS)数据库,该数据库将SEER数据库与疾病控制和预防中心(CDC)的国家癌症登记计划(NPCR)相结合,覆盖了美国所有50个州,以研究食管癌的发病率。
方法
使用USCS登记处获取2001年至2015年食管癌的数据。发病率分析根据性别、种族、分期、组织学以及美国地区位置/组织学进行分层。
结果
2001 - 2015年食管癌的总体发病率为每年每10万人中4.7例。在男性、黑人、远处疾病、腺癌以及中西部患有腺癌的人群中,各分层的总体发病率最高。与其他种族相比,黑人在2001 - 2015年期间发病率的统计学显著下降幅度最大(年变化百分比(APC)-4.55)。2011年至2015年,东北部腺癌患者的发病率增长也最为迅速(APC 2.16)。
结论
在我们的研究中,我们能够利用来自美国所有50个州的数据确定食管癌的发病率。我们关于黑人发病率下降以及中西部和东北部腺癌发病率上升的发现有助于阐明高危人群。此外,我们的发现有助于揭示可能导致食管癌发生的风险因素,以及如何基于这些风险因素改进诊断和监测。