Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Cancer Epidemiol. 2023 Dec;87:102486. doi: 10.1016/j.canep.2023.102486. Epub 2023 Nov 11.
BACKGROUND: Esophageal cancer (EC) is a malignancy with a poor prognosis. We provided a global overview of EC mortality, analyzing figures over the last three decades and estimating mortality rates for the year 2025. We also reported incidence trends and the distribution of squamous cell carcinoma (SCC) and adenocarcinoma (AC) in selected countries. METHODS: We considered EC trends in the age-standardised mortality rates (ASMR) from the World Health Organization database for selected countries. To estimate the number of deaths and ASMRs for 2025, we applied a Poisson linear regression model to the latest trend segment identified using a joinpoint model. We reported EC incidence trends according to histology using the Cancer Incidence in Five Continents database for the calendar period of 1990-2012. RESULTS: In 2015-19, the male ASMRs/100,000 were 4.01 in the EU-27, 4.28 in the USA, and 5.10 in Japan. The corresponding female rates ranged from 0.82 to 0.85/100,000. Male mortality showed a decreasing trend in most countries analyzed, with earlier and steeper declines in southern Europe. Conversely, ASMRs were increasing in Belarus, Finland, Greece, and Cuba. Female mortality showed a slight increase in several European countries, while North America, Latin America, and Australasia showed favorable trends. Projections suggest that male EC mortality is expected to decline in all countries except the Russian Federation. Female favorable trends are also predicted in most countries, except for France, Germany, the Russian Federation, and Canada. SCC remained the most common histotype, but AC incidence showed an upward trend, particularly in high-income countries. CONCLUSION: The observed trends in EC mortality reflect variations in patterns of major risk factors. Effective control of risk factors would contribute to reducing the burden of EC, together with early diagnosis and potential improvements in treatments.
背景:食管癌(EC)是一种预后不良的恶性肿瘤。我们提供了全球食管癌死亡率的概述,分析了过去三十年的数据,并估算了 2025 年的死亡率。我们还报告了部分国家的发病率趋势以及鳞状细胞癌(SCC)和腺癌(AC)的分布情况。
方法:我们考虑了世界卫生组织数据库中选定国家食管癌年龄标准化死亡率(ASMR)的趋势。为了估算 2025 年的死亡人数和 ASMR,我们应用泊松线性回归模型对使用连接点模型确定的最新趋势段进行了分析。我们根据组织学报告了 1990 年至 2012 年癌症发病率在五大洲数据库中的食管癌发病率趋势。
结果:2015-2019 年,欧盟 27 国、美国和日本的男性 ASMR/100,000 分别为 4.01、4.28 和 5.10。相应的女性比率范围为 0.82 至 0.85/100,000。在分析的大多数国家中,男性死亡率呈下降趋势,南欧的下降更为陡峭。相反,白俄罗斯、芬兰、希腊和古巴的 ASMR 呈上升趋势。一些欧洲国家的女性死亡率略有上升,而北美、拉丁美洲和澳大拉西亚则呈现出有利的趋势。预测显示,除俄罗斯联邦外,所有国家的男性食管癌死亡率预计都将下降。除法国、德国、俄罗斯联邦和加拿大外,大多数国家的女性死亡率也有望下降。SCC 仍然是最常见的组织学类型,但 AC 的发病率呈上升趋势,尤其是在高收入国家。
结论:观察到的食管癌死亡率趋势反映了主要危险因素模式的变化。有效控制危险因素将有助于降低食管癌的负担,同时还需要早期诊断和潜在的治疗改进。
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