Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, UK.
Gut. 2021 Feb;70(2):234-242. doi: 10.1136/gutjnl-2020-321089. Epub 2020 Jun 17.
Survival from oesophageal cancer remains poor, even across high-income countries. Ongoing changes in the epidemiology of the disease highlight the need for survival assessments by its two main histological subtypes, adenocarcinoma (AC) and squamous cell carcinoma (SCC).
The ICBP SURVMARK-2 project, a platform for international comparisons of cancer survival, collected cases of oesophageal cancer diagnosed 1995 to 2014, followed until 31 December 2015, from cancer registries covering seven participating countries with similar access to healthcare (Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK). 1-year and 3-year age-standardised net survival alongside incidence rates were calculated by country, subtype, sex, age group and period of diagnosis.
111 894 cases of AC and 73 408 cases of SCC were included in the analysis. Marked improvements in survival were observed over the 20-year period in each country, particularly for AC, younger age groups and 1 year after diagnosis. Survival was consistently higher for both subtypes in Australia and Ireland followed by Norway, Denmark, New Zealand, the UK and Canada. During 2010 to 2014, survival was higher for AC compared with SCC, with 1-year survival ranging from 46.9% (Canada) to 54.4% (Ireland) for AC and 39.6% (Denmark) to 53.1% (Australia) for SCC.
Marked improvements in both oesophageal AC and SCC survival suggest advances in treatment. Less marked improvements 3 years after diagnosis, among older age groups and patients with SCC, highlight the need for further advances in early detection and treatment of oesophageal cancer alongside primary prevention to reduce the overall burden from the disease.
即使在高收入国家，食管癌的生存率仍然很低。该疾病的流行病学持续变化，突出了对其两种主要组织学亚型（腺癌[AC]和鳞状细胞癌[SCC]）进行生存评估的必要性。
国际癌症生存比较计划（ICBP SURVMARK-2）项目是一个国际癌症生存比较的平台，该项目收集了 1995 年至 2014 年期间被诊断为食管癌的病例，随访至 2015 年 12 月 31 日，这些病例来自覆盖七个具有相似医疗保健机会的参与国家的癌症登记处（澳大利亚、加拿大、丹麦、爱尔兰、新西兰、挪威和英国）。通过国家、亚型、性别、年龄组和诊断期计算了 1 年和 3 年年龄标准化净生存率以及发病率。
共纳入了 111894 例 AC 和 73408 例 SCC 病例。在 20 年期间，每个国家的生存率都有显著提高，尤其是 AC、年龄较小的年龄组和诊断后 1 年。澳大利亚和爱尔兰的两种亚型的生存率一直较高，其次是挪威、丹麦、新西兰、英国和加拿大。2010 年至 2014 年期间，AC 的生存率高于 SCC，1 年生存率从加拿大的 46.9%到爱尔兰的 54.4%不等，而 SCC 的生存率从丹麦的 39.6%到澳大利亚的 53.1%不等。
食管 AC 和 SCC 生存率的显著提高表明治疗取得了进展。在诊断后 3 年，年龄较大的年龄组和 SCC 患者的生存率提高幅度较小，这突出表明需要进一步提高食管癌的早期检测和治疗水平，同时进行初级预防，以降低该疾病的整体负担。
