Mo1998 Adenocarcinoma of the Esophagogastric Junction Is Still Low in Japan -Multicenter Epidemiological Study in Kurashiki, Japan

Abstract

Background & Aims: In Asia, gastroesophageal reflux disease (GERD) related diseases such as Barrett's esophagus (BE) and adenocarcinoma of the esophagogastric junction (AEGJ), have traditionally been considered less common than in Western countries. Although the number of reported cases of these conditions in Japan has been gradually increasing in recent years, little is known about the epidemiology of AEGJ. The aim of this study was to investigate the clinicoepidemiological characteristics of AEGJ in Japan. Methods: From January 2008 to June 2010, 88,199 consecutive cases (48,548 males and 39,651 females; mean age, 62 years) of upper gastrointestinal (GI) endoscopies performed at 12 hospitals in Kurashiki, Japan were recruited. They were prospectively followed up for a mean period of 4.0 years. For a 6.5-year period ranging from January 2008 to June 2014, we reviewed all endoscopic reports and associated medical records. AEGJ was defined as an adenocarcinoma of the distal esophagus (Siewert Type I) and a true carcinoma of the cardia (Siewert Type II). Furthermore, risk factors associated with AEGJ were identified by comparing data from AEGJ patients with age and gender matched controls using a multiple logistic regression method. Results: During the study period, 83 patients with AEGJ were identified (72 males and 11 females; mean age, 68 years); six patients of Siewert Type I and 77 patients of Siewert Type II. The incidence rate of AEGJ was in the range of 0.9 1.5 per 100,000 person-years and did not increase by year. Results of univariate analysis were shown in Table 1. Multivariate analysis showed that risk factors for AEGJ included obesity [body mass index (BMI) > 25 kg/m2] (Odds ratio (OR) = 3.33; 95% confidence interval (CI), 1.57 7.08; P = 0.002), hiatal hernia (OR= 2.08; 95% CI, 1.04 4.18; P = 0.039), and smoking (OR= 1.92; 95% CI, 1.01 3.65; P = 0.047). Conclusions: The incidence of AEGJ is still lower in Japan than in Western countries, although similar risk factors of AEGJ as western patients are detected such as obesity, hiatal hernia, smoking, and male gender. Table 1. Results of univariate analysis for AEGJ