The incidence of esophageal cancer in the United States declined from 1975 to 2018, according to research published in JAMA Network Open.
There was a significant decline in the incidence of squamous cell carcinoma, but the incidence of adenocarcinoma plateaued, researchers found.
This study included 47,648 patients who were diagnosed with esophageal cancer from 1975 to 2018. The researchers used data from 9 SEER registries for the entire study period and 21 SEER registries for the period from 2000 through 2018.
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The age-adjusted incidence rate (AAIR) of esophageal cancer increased slightly from 4.14 per 100,000 population in 1975 to 4.18 per 100,000 in 2018. The AAIR of squamous cell carcinoma decreased from 3.06 in 1975 to 1.15 in 2018, and the AAIR of adenocarcinoma increased from 0.42 to 2.78.
The researchers noted that the histologic subtype responsible for most esophageal cancer cases shifted from squamous cell carcinoma (73.91% of cases in 1975) to adenocarcinoma (66.51% of cases in 2018).
According to the SEER 9 data, the incidence of esophageal cancer increased from 1975 to 2004 (annual percentage change [APC], 0.53; 95% CI, 0.4 to 0.7) but decreased from 2004 to 2018 (APC, −1.03; 95% CI, −1.3 to −0.7). The SEER 21 data also showed a decrease in esophageal cancer incidence from 2004 to 2018 (APC, −1.25; 95% CI, −1.5 to −1.0).
The SEER 9 data suggested that the incidence of squamous cell carcinoma was stable from 1975 to 1986, decreased from 1986 to 2011 (APC, −3.28; 95% CI, −3.5 to −3.0), and stabilized again after 2011. The SEER 21 data suggested that the incidence of squamous cell carcinoma declined from 2000 to 2018 (APC, −2.80; 95% CI, −3.0 to −2.6).
The SEER 9 data suggested that adenocarcinoma incidence increased substantially from 1975 to 1999 (APC, 7.61; 95% CI, 7.0 to 8.2), and the increase was smaller from 1999 to 2018 (APC, 0.56; 95% CI, 0.1 to 1.0). According to the SEER 21 data, the incidence of adenocarcinoma increased from 2000 to 2006 (APC, 2.51; 95% CI, 1.0 to 4.0) and stabilized thereafter.
“Further studies are needed to identify the factors contributing to these patterns in incidence, particularly why the adenocarcinoma incidence has plateaued for more than a decade and has not continued to decrease like squamous cell carcinoma,” the researchers concluded.
Reference
Rodriguez GM, DePuy D, Aljehani M, et al. Trends in epidemiology of esophageal cancer in the US, 1975-2018. J Natl Cancer Inst. Published online August 22, 2023. doi:10.1001/jamanetworkopen.2023.29497
This article originally appeared on Cancer Therapy Advisor
