Continuing Rapid Increase in Esophageal Adenocarcinoma in... : Official journal of the American College of Gastroenterology | ACG (original) (raw)

ORIGINAL CONTRIBUTION

Lepage, Côme M.D., Ph.D.2; Rachet, Bernard M.D., Ph.D.1; Jooste, Valérie Ph.D.2; Faivre, Jean M.D., Ph.D.2; Coleman, Michel P. M.D., Ph.D.1

1London School of Hygiene & Tropical Medicine, London, UK; and 2INSERM U 866, Registre bourguignon des cancers digestifs, Université de Bourgogne, Dijon, France

Reprint requests and correspondence: C. Lepage, M.D., Ph.D., Registre bourguignon des cancers digestifs [INSERM U 866], BP 87900, F-21079 Dijon Cedex, France.

Received May 6, 2008; accepted July 14, 2008.

Abstract

BACKGROUND AND AIMS

Substantial changes have occurred in the epidemiology of esophageal adenocarcinoma. We examined trends in incidence in a large national population.

METHODS

All esophageal adenocarcinomas registered in England and Wales over a 31-year period (1971–2001) were included. Incidence rates were calculated by age, sex, and socio-economic category, by 5-year period, and by birth cohort.

RESULTS

A total of 43,753 esophageal adenocarcinomas were analyzed. Age-standardized (world) incidence rates rose rapidly, by an average of 39.6% (95% CI 38.6–40.6) every 5 years in men, and 37.5% (35.8–39.2) every 5 years in women. Incidence has increased about three-fold in men and women since 1971. Incidence has risen in all deprivation categories since 1986, especially in the most affluent groups. The cumulative risk of esophageal adenocarcinoma over the age range 15–74 years in men rose ten-fold, from 0.1% for those born in 1900 to 1.1% for those born in 1940. The cumulative risk rose five-fold in women.

CONCLUSIONS

The incidence of esophageal adenocarcinoma has increased sharply over the past few decades, both by period and birth cohort. Etiological studies are required to explain the rapid increase of this lethal cancer.