Li Jiayue, Sun Kexin, Zhu Qian, Wen Xiaolan, Lin Xinmei, Li Li, Chen Ru, Zheng Rongshou, Wei Wenqiang, Wang Shaoming
National Central Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
China CDC Wkly. 2025 Apr 11;7(15):491-496. doi: 10.46234/ccdcw2025.082.
WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Esophageal cancer (EC) consists of two main histological subtypes: esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC), each with distinct epidemiological patterns. Historically, ESCC has been the dominant subtype worldwide, especially in Asian countries. However, in recent decades, the incidence of EAC has been rising rapidly, particularly in European and American countries, reflecting significant shifts in global EC epidemiology.
WHAT IS ADDED BY THIS REPORT?: This study presents a comprehensive analysis of 25 years of high-quality continuous data on ESCC and EAC incidence trends across 25 countries. It highlights declining ESCC rates in most regions, rising EAC rates in Western nations, pronounced sex differences, and narrowing ESCC-to-EAC ratios. These diverse trends reveal the need to investigate region-specific risk factors and their contributions to the shifting burden of EC globally.
WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: The distinct trends of ESCC and EAC call for tailored public health strategies based on regional and histological patterns. Countries experiencing a rising burden of EAC or ESCC can implement targeted risk factor prevention and control measures to address the increasing trends. In clinical practice, a stronger focus on EAC in high-income countries and ESCC in regions, where it remains dominant, can improve early detection and treatment outcomes. Understanding these evolving patterns will aid in designing evidence-based interventions and optimizing resource allocation to reduce the global esophageal cancer burden effectively.
关于该主题已知的信息有哪些？：食管癌（EC）主要由两种组织学亚型组成：食管鳞状细胞癌（ESCC）和食管腺癌（EAC），每种亚型都有不同的流行病学模式。从历史上看，ESCC在全球范围内一直是主要亚型，尤其是在亚洲国家。然而，近几十年来，EAC的发病率一直在迅速上升，特别是在欧美国家，这反映了全球食管癌流行病学的显著变化。
本报告新增了哪些内容？：本研究对25个国家25年来关于ESCC和EAC发病率趋势的高质量连续数据进行了全面分析。它强调了大多数地区ESCC发病率下降、西方国家EAC发病率上升、明显的性别差异以及ESCC与EAC比例缩小的情况。这些不同的趋势表明有必要调查特定区域的风险因素及其对全球食管癌负担变化的影响。
对公共卫生实践有何启示？：ESCC和EAC的不同趋势要求根据区域和组织学模式制定有针对性的公共卫生策略。EAC或ESCC负担上升的国家可以实施有针对性的风险因素预防和控制措施，以应对不断上升的趋势。在临床实践中，高收入国家更关注EAC，而在ESCC仍占主导地位的地区更关注ESCC，可以改善早期发现和治疗效果。了解这些不断变化的模式将有助于设计基于证据的干预措施并优化资源分配，以有效减轻全球食管癌负担。
