The epidemiological trends and predictions of esophageal squamous cell carcinoma and gastroesophageal junction carcinoma: an Australian population-based study.

BACKGROUND

Gastroesophageal junction carcinoma (GEJC) and esophageal squamous cell carcinoma (ESCC) are increasing in Australia and other Western countries. We aimed to investigate past trends and predict the future direction of GEJC and ESCC cases.

METHODS

Data on GEJC and ESCC were extracted from the Australian Cancer Database, and the National Mortality Database for the Australian states of Victoria, Queensland, Tasmania, and the Australian Capital Territory. The new number of cases were predicted up to 2039 by fitting a least squares linear regression using the Australian incidence rates trend from 2009 to 2018. Past trends were analyzed for prevalence and mortality. Kaplan-Meier curves generated the survival trend for up to 10 years.

RESULTS

Between 2009 and 2018, the overall incidences of GEJC showed an increasing trend (annual change [β] = 0.87, P < 0.05). For GEJC, the rates of incidence, prevalence, and mortality were higher in men (β = 1.86, 95% CI: 1.29-2.43, P < 0.05; β = 14.45, 95% CI: 12.93-15.98, P < 0.05; β = 1.04, 95% CI: - 0.68 to 2.76, P = 0.195, respectively) than in women. By 2039, it is estimated that 6 in 100,000 population will be newly diagnosed with GEJC. Notably, the rate of new GEJC cases decreased in women during the study period (β=-0.08, 95% CI: - 0.39 to 0.24, P = 0.596). For ESCC, the incidence rate increased, albeit at a slower rate compared with GEJC (β = 0.87, 95% CI: 0.6-1.15, P < 0.05; β = 0.03, 95% CI: - 0.28 to 0.34, P = 0.805, respectively). New cases of ESCC in men declined (β=-0.03, 95% CI: - 0.46 to 0.4, P = 0.884). By 2039, it is predicted that 2 in 100,000 people will be newly diagnosed. The 10-year survival rate for GEJC and ESCC was low (11% and 20%, respectively), while the survival rate for women was relatively higher than for men.

CONCLUSION

The incidence, prevalence, and mortality would be predicted to increase in 2039 if there were no significant changes in risk factors, diagnosis, treatment, and management compared with 2009-2018. Strategies to identify early signs and enable earlier diagnosis and early and new treatment options are essential in GEJC and ESCC.