Epidemiology of early esophageal adenocarcinoma

• Type of Material: Article
• Authors: Thuy-Van P. Hang, Emory University; Zachary Spiritos, Duke University; Anthony M. Gamboa, Vanderbilt University; Zhengjia Chen, Emory University; Seth Force, Emory University; Vaishali Patel, Emory University; Saurabh Chawla, Emory University; Steven Keilin, Emory University; Nabil Saba, Emory University; Bassel El-Rayes, Emory University; Qiang Cai, Emory University; Field Willingham, Emory University
• Language: English
• Date: 2022-05-01
• Publisher: Hoon Jai Chun
• Publication Version: Final Published Version
• Copyright Statement: © 2022 Korean Society of Gastrointestinal Endoscopy
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.5946/ce.2021.152
• Title of Journal or Parent Work: Clinical Endoscopy
• Volume: 55
• Issue: 3
• Start Page: 372
• End Page: 380
• Grant/Funding Information: This work was supported by a development grant from the Department of Medicine at Emory University School of Medicine. This work was also supported by grant P30CA138292 from the Biostatistics and Bioinformatics Shared Resource of Winship Cancer Institute of Emory University and NIH/NCI. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
• Keywords: Esophageal neoplasm; Epidemiology; Adenocarcinoma; Barrett’s esophagus
• Research Categories: Health Sciences, Epidemiology

Abstract

Background/Aims Endoscopic resection has become the preferred treatment approach for select early esophageal adenocarcinoma (EAC); however, the epidemiology of early stage disease has not been well defined. Methods Surveillance Epidemiology and End Results (SEER) data were analyzed to determine age-adjusted incidence rates among major epithelial carcinomas, including EAC, from 1973 to 2017. The percent change in incidence over time was compared according to tumor subtype. Early T-stage, node-negative EAC without metastasis was examined from 2004 to 2017 when precise T-stage data were available. Results The percent change in annual incidence from 1973 to 2017 was 767% for EAC. Joinpoint analysis showed that the average annual percent change in EAC from 1973 to 2017 was 5.11% (95% confidence interval, 4.66%–5.56%). The annual percent change appeared to plateau between 2004 and 2017; however, early EAC decreased from 2010 to 2017, with an annual percent change of –5.78%. Conclusions There has been a 7-fold increase in the incidence of EAC, which was significantly greater than that of the other major epithelial malignancies examined. More recently, the incidence of early EAC has been decreasing. Approximately one in five patients has node negative, potentially resectable early stage disease.