A multinational assessment of gastric and esophageal cancer burden by age, gender, and disease characteristics.

Abstract

29 Background: Gastric and esophageal cancers are the fourth and eighth most common cancers worldwide, with an estimated 1.5 million new cases combined in 2008. A comprehensive, international comparison of the descriptive epidemiology of these diseases is lacking. The objectives of this study are to (1) characterize the current and projected incidence rates and the current case fatality of these cancer types by age and gender within countries in Europe, Asia, the Americas, Oceania, and Africa; (2) describe the temporal variation in cardia and non-cardia gastric cancer and squamous and adenocarcinoma esophageal cancer in the U.S. by age and gender. Methods: Data from GLOBOCAN were used to calculate country-specific incidence rates (per 100,000) for 2012, 2015, and 2025, and the country-specific case fatality (%) in 2012. Data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program in the U.S. were used to estimate gastric cancer incidence rates from 2004-2011 (per 100,000) and 12-month survival (%) stratified by gender, age (0-64/65+), stage at diagnosis, gastric cancer subtype, and esophageal cancer histology. Joinpoint regression was used to quantify changes in the Average Annual Percent Change (AAPC) in these outcomes. Results: GLOBOCAN results showed wide geographic variation in gastric and esophageal cancer incidence rates. In most countries, the case-fatality among males and females 65+ years was > 60%. In the U.S., the annual incidence of all gastric cancer subtypes decreased significantly among males and females 65+ (AAPC= -2.4% & -1.6%, respectively). Esophageal cancer incidence decreased in both genders and age groups, with a significant decline observed among females 65+ with squamous histology (-3.5%). Twelve-month survival in esophageal cancer showed modest improvements, with a significant increase observed among males 65+ with adenocarcinoma histology (2.0%). Conclusions: The worldwide burden of gastric and esophageal cancers is substantial. In the U.S., declines in incidence and modest improvements in survival of these cancers were observed.