Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Thorac Cancer. 2020 May;11(5):1121-1128. doi: 10.1111/1759-7714.13311. Epub 2020 Mar 10.
Recent studies have indicated that the incidence of esophageal cancer has declined in the past decade in the U.S. However, trends in the incidence and survival have not been thoroughly examined.
Data from 46 063 patients with esophageal cancer between 1973 and 2015 were collected from the Surveillance, Epidemiology, and End Results database. The trends in the age-adjusted incidence and survival were analyzed using joinpoint regression models.
The age-adjusted incidence of esophageal cancer increased from 5.55 to 7.44 per 100 000 person-years between 1973 and 2004. Later, it decreased at an annual percentage change of 1.23%. In the last 40 years, the strong male predominance increased slightly. Importantly, the percentage of patients with localized stage of squamous cell cancer decreased. It was observed that the incidence of esophageal squamous cell carcinoma declined since 1986, while the incidence of esophageal adenocarcinoma sharply increased since 1973 and surpassed the rate of squamous cell cancer, mainly due to the increase in the incidence among men. Consistently, the estimated 40-year limited-duration prevalence of esophageal adenocarcinoma was higher than that of esophageal squamous cell carcinoma. Additionally, we observed a modest but significant improvement in survival during the study period.
The incidence of esophageal squamous cell carcinoma has decreased significantly over the past four decades in the U.S., while the incidence of adenocarcinoma has increased, particularly among men. Overall, the long-term survival of patients with esophageal cancer is poor but it has improved over the past decades, especially for the localized disease.
Significant findings of the study The incidence of esophageal cancer has decreased at an annual percentage change of 1.23% since 2004. The incidence of esophageal adenocarcinoma has sharply increased since 1973 and surpassed the rate of squamous cell cancer, mainly due to the increase in the incidence among men. What this study adds There has been a shift in the prevalence of esophageal cancer histological subtypes over the past decades in the U.S. We found that the incidence of esophageal squamous cell carcinoma has continued to decrease, while the esophageal adenocarcinoma rate has continued to increase.
最近的研究表明，美国过去十年食管癌的发病率有所下降。然而，发病率和生存率的趋势尚未得到彻底检查。
从 1973 年至 2015 年，从监测、流行病学和最终结果数据库中收集了 46063 名食管癌患者的数据。使用 joinpoint 回归模型分析了年龄调整发病率和生存率的趋势。
1973 年至 2004 年，食管癌的年龄调整发病率从 5.55 增加到 7.44/10 万人口。此后，它以每年 1.23%的速度下降。在过去的 40 年里，男性占比略有增加。重要的是，局限性鳞状细胞癌患者的比例有所下降。观察到自 1986 年以来食管鳞状细胞癌的发病率下降，而自 1973 年以来食管腺癌的发病率急剧上升，主要是由于男性发病率的增加。一致地，估计的 40 年有限期食管腺癌的患病率高于食管鳞状细胞癌。此外，我们观察到在研究期间生存状况有适度但显著的改善。
在过去的四十年中，美国食管鳞状细胞癌的发病率显著下降，而腺癌的发病率上升，尤其是在男性中。总体而言，食管癌患者的长期生存率较差，但在过去几十年中有所改善，特别是对于局限性疾病。
自 2004 年以来，食管癌的发病率每年以 1.23%的速度下降。自 1973 年以来，食管腺癌的发病率急剧上升，超过了鳞状细胞癌的发病率，主要是由于男性发病率的增加。
在过去几十年中，美国食管癌的组织学亚型流行率发生了变化。我们发现食管鳞状细胞癌的发病率继续下降，而食管腺癌的发病率继续上升。
