Abstract
To establish the prevalence and distribution profile of esophageal squamous cell carcinomas (ESCCs) over a 22-yr period in North China. Using endoscopy for primary diagnosis and histological analysis for the further confirmation, a total of 74,854 ESCC patients aged 20-89 between January 1985 and December 2006 were investigated to analyze the epidemiological profile including prevalence rates, distribution of age-of-onset, gender and geographical area of ESCC in Luoyang, the highest incidence area of North China. A total of 4092 cases of ESCC were finally diagnosed among 74,854 patients who had their first endoscopies. The prevalence among males was higher than that among females (p<0.01), resulting in an overall male:female OR of 1.2 (95%CI, 1.2-1.3). The prevalence in rural areas was higher than in urban areas (p<0.01), resulting in an overall rural:urban OR of 2.6 (95%CI, 2.4-2.9). The rural:urban ORs and the 95% CI increased continuously from 2.6, 2.3-3.0 to 2.7, 2.2-3.3, respectively, for 4 consecutive periods during the 22-yr study period. Moreover, the median age of onset among females was higher than that among males (p<0.01). For both sexes and in both areas, the prevalence rates declined and the median age of onset rose for 4 consecutive periods in the 22-yrs time frame (p<0.01). [corrected] These data reveal the epidemiological profile of ESCC in the area of North China, and suggest that urban areas and rural people account for a growing proportion of the ESCC patients although the prevalence of ESCC significantly declined and the median age-of-onset postponed over the 22-yrs period. Moreover, the prevalence status of ESCC in rural areas also underlines the need for public health initiatives aimed at reducing risk factors of this fatal disease.
Highlights
Esophageal cancer (EC) is the 8th most common cancer worldwide and the 6th leading cause of cancer deaths (Parkin et al, 2001; Jemal et al, 2011)
Conculsions: These data reveal the epidemiological profile of esophageal squamous cell carcinomas (ESCCs) in the area of North China, and suggest that urban areas and rural people account for a growing proportion of the ESCC patients the prevalence of ESCC significantly declined and the median age-of-onset postponed over the 22-yrs period
We found for the overall patients during last 22-year periods, 2, 487 males and 1605 females were confirmed with ESCC from the 42, 146 male and 32, 709 female first endoscopy examination receivers, respectively
Summary
Esophageal cancer (EC) is the 8th most common cancer worldwide and the 6th leading cause of cancer deaths (Parkin et al, 2001; Jemal et al, 2011). Whereas the clinical statistical data of esophageal adenocarcinoma was well documented in most western countries, the epidemiological profile including prevalence and the distribution of age, gender, and area of Esophageal Squamous Cell Carcinoma (ESCC) in North China, the area with highest incidence, is very limited (Das, 2010). Endoscopy has not been accepted to apply in large-scale population surveys because of the intolerable invasive suffering and the higher cost for the patients in developing countries In this regard, van Blankenstein (van Blankenstein et al, 2005) was the first to employ a large amount of the primary endoscopy patients at the endoscopy unit, replacing the large-scale population survey, to describe the prevalence and distribution of Barrett’s Esophagus (BE). A total of 492 cases of BE were identified in 21, 899 first endoscopies, the prevalence and age, gender distribution of BE was successfully described, and
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