Recent trends in the epidemiology of esophageal cancer. Comparison of epidermoid- and adenocarcinomas.

This was a retrospective study of 306 consecutive patients with esophageal carcinoma seen at the Saskatoon Cancer Center from 1970 to 1992, making an annual incidence of approximately 2.7 percent per 100,000 population. The two main cancer types were (1) epidermoid carcinoma (199 patients or 69 percent), and (2) adenocarcinoma (81 patients or 28 percent). At the time of diagnosis, all patients had advanced disease with > 60 percent having extra-esophageal spread. Patient management was conventional with radiotherapy, surgery, chemotherapy, or combinations thereof being the mainstay of treatment. After a mean follow-up of 13 months, 82 percent of the patients had died of disease, 11 percent of other causes, and none were cured of disease. An analysis of the time trends showed an increasing incidence of both epidermoid carcinomas and adenocarcinomas, particularly the latter. There was a preponderance of distally located tumors in either group. The reasons for these trends in the pathobiology of esophageal carcinoma are not fully understood at this time.