National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Int J Cancer. 2023 Jan 15;152(2):151-161. doi: 10.1002/ijc.34232. Epub 2022 Aug 20.
Adenocarcinoma (AC) and squamous cell carcinoma (SCC) are the main subtypes of esophageal cancer (EC), but nationwide survival of both EC subtypes has never been reported in China. Our study aimed to estimate the survival trends of EC by subtype in China and compare them with those in the United States for the same period. We used data from 64 Chinese cancer registries, which included EC patients diagnosed during 2008 and 2015 and followed up until 31st December 2017. The 5-year age-standardized relative survival by subtype, sex, age group and urban or rural area between 2008 and 2017 were analyzed. We stratified survival estimates by calendar period (2008-2009, 2010-2011, 2012-2014 and 2015-2017). Data from the SEER 18 program were calculated to estimate the survival of EC in the United States. A further comparison between the survivals in areas covered and not covered by population-based endoscopic screening programs in China was conducted. A total of 129 962 records were included in the survival analyses. Results revealed that age-standardized 5-year relative survivals for AC and SCC increased in both China and the United States from 2008 to 2017. In 2015 to 2017, 5-year survival from both subtypes in China was better than the United States (SCC: 36.9% vs 18.5%, AC: 34.8% vs 22.3%). The survival for both subtypes was significantly higher in screening areas than in nonscreening areas in China (SCC: 40.6% vs 32.8%; AC: 43.0% vs 31.3%). A survival gap in EC by subtype exists between China and the United States. Our results may support the beneficial effect of population-based endoscopic screening for survival, and may be poised to inform national policy-making in both countries.
腺癌（AC）和鳞状细胞癌（SCC）是食管癌（EC）的主要亚型，但中国从未报告过这两种 EC 亚型的全国生存率。我们的研究旨在估计中国 EC 亚型的生存趋势，并将其与同期美国的情况进行比较。我们使用了来自 64 个中国癌症登记处的数据，这些数据包括 2008 年至 2015 年期间诊断出的 EC 患者，并随访至 2017 年 12 月 31 日。分析了 2008 年至 2017 年期间按亚型、性别、年龄组和城乡划分的 5 年年龄标准化相对生存率。我们按日历时间（2008-2009 年、2010-2011 年、2012-2014 年和 2015-2017 年）对生存估计进行分层。使用 SEER 18 计划的数据计算了美国 EC 的生存率。进一步比较了中国覆盖和未覆盖人群内镜筛查计划地区的生存率。生存分析共纳入 129962 例患者。结果显示，2008 年至 2017 年，中国和美国的 AC 和 SCC 的年龄标准化 5 年相对生存率均有所提高。2015 年至 2017 年，中国两种亚型的 5 年生存率均优于美国（SCC：36.9% vs 18.5%，AC：34.8% vs 22.3%）。中国筛查地区的两种亚型生存率均明显高于非筛查地区（SCC：40.6% vs 32.8%；AC：43.0% vs 31.3%）。中国和美国之间存在 EC 亚型的生存差距。我们的结果可能支持基于人群的内镜筛查对生存的有益影响，并可能为两国的国家决策提供依据。
