Department of Internal Medicine and Gastroenterology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic; Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic.
Cancer Epidemiol. 2020 Dec;69:101853. doi: 10.1016/j.canep.2020.101853. Epub 2020 Nov 5.
Incidence of esophageal adenocarcinoma (EAC) associated with gastroesophageal reflux disease has increased substantially in developed countries during the past decades. We aimed to analyze trends in incidence of esophageal cancer (EC) by histological subtypes and trends in acid suppressing drugs prescription in the Czech Republic.
The incidence of EC by histological subtypes, sex, and stage from 1984-2017 was examined using data from the Czech National Cancer Registry. Defined daily doses of acid inhibiting drugs were analyzed from annual reports by the State Institute for Drug Control.
Age standardized incidence of EAC in men increased annually by 4.88 % with 95 % confidence interval (CI) (4.32, 5.45) from 1984 to 2017, and by 5.11 % (95 % CI, 4.02, 6.20) in women. Squamous cell carcinoma increased annually by 5.52 % (95 % CI, 2.49, 8.64) from 1984 to 1994 with subsequent slower increase by 0.87 % (95 % CI, 0.25, 1.50) from 1994 to 2017. It still represents 50 % of all EC in 2017. The comparable early stages of EAC showed similar annual percentage change of 5.77 %. From 2001 to 2018 the use of proton pump inhibitors increased dramatically from 6.8 to 72.9 defined daily doses per 1000 inhabitants.
The incidence of EAC is still increasing in the Czech Republic, however it represents less than half of ECs. The incidence of squamous cell carcinoma is relatively stable. Broad use of acid suppressing drugs did not seem to impact the incidence of EAC even in early stages.
在过去几十年中，与胃食管反流病相关的食管腺癌（EAC）在发达国家的发病率显著增加。本研究旨在分析捷克共和国食管癌症（EC）的组织学亚型的发病率趋势以及抑酸药物处方的趋势。
利用捷克国家癌症登记处的数据，对 1984 年至 2017 年期间不同组织学亚型、性别和分期的 EC 发病率进行了研究。通过国家药物管制研究所的年度报告分析了抑酸药物的定义日剂量。
1984 年至 2017 年间，男性 EAC 的年龄标准化发病率每年增加 4.88%（95%置信区间（CI）为 4.32%至 5.45%），女性每年增加 5.11%（95%CI 为 4.02%至 6.20%）。1984 年至 1994 年间，鳞状细胞癌每年增加 5.52%（95%CI 为 2.49%至 8.64%），随后至 2017 年缓慢增加 0.87%（95%CI 为 0.25%至 1.50%）。2017 年它仍占所有 EC 的 50%。同期 EAC 的早期阶段的年变化百分比也相似，为 5.77%。从 2001 年到 2018 年，质子泵抑制剂的使用量从 6.8 个增至 72.9 个，每 1000 名居民的定义日剂量。
在捷克共和国，EAC 的发病率仍在上升，但它仅占 EC 的一半以下。鳞状细胞癌的发病率相对稳定。即使在早期阶段，广泛使用抑酸药物似乎也没有对 EAC 的发病率产生影响。
