Incidence Rates Of Esophageal Cancer Research Articles

Characteristics of Esophageal Cancer Cases in Tanzania.

PurposeAge-standardized incidence rates for esophageal cancer (EC) in East Africa have been reported as disproportionately high compared with the worldwide incidence of nine per 100,000 population. This study aimed to characterize EC cases seen at Muhimbili National Hospital and Ocean Road Cancer Institute in Dar es Salaam, Tanzania.MethodsDemographic, clinical, and treatment variables were abstracted from charts of patients who received care for a diagnosis of EC at one or both institutions between 2011 and 2013. Categorical data were summarized as frequency counts and percentages. Continuous data were presented as medians and ranges. To compare men and women, Pearson’s χ2 and two-sample t tests were applied.ResultsSeven hundred thirty-eight unique cases of EC were identified, of whom 68% were men and the median age was 60 years (range, 19 to 95 years). Notably, 93 cases (13%) were ≤ 40 years old at diagnosis. Squamous cell carcinoma was the dominant histology, comprising 90% of cases with documented histopathology. However, 34% of cases with a diagnosis of EC were not pathologically confirmed. The stage was documented as locoregional in 4% of cases, locally advanced in 20% of cases, metastatic in 14% of cases, and unknown in 63% of cases. Of 430 patients who received treatment at Ocean Road Cancer Institute, 76% were treated with radiation, 44% were treated with chemotherapy, 3% underwent a cancer-related surgical procedure, and 10% of cases received no cancer-directed therapy. The median overall survival for all patients was 6.9 months (95% CI, 5.0 to 12.8), regardless of stage at presentation.ConclusionBetween 2011 and 2013, cases of EC represented a large clinical burden at both institutions.

Estimated of esophageal cancer incidence and mortality in China, 2013

Objective: The National Central Cancer Registry (NCCR) collected esophageal data of local cancer registries in 2013 to estimate the incidence and mortality in China. Methods: Data submitted from 347 registries were evaluated and 255 registries' data are qualified by NCCR. Data of incidence and mortality were stratified with areas (urban/rural), gender and age group. Chinese population census in 2000 and Segi's population were used for age-standardized incidence/mortality. Results: All of 255 cancer registries covered a total of 226 494 490 population (111 595 772 in urban areas and 114 898 718 in rural areas). The morphology verified cases (MV%) of esophageal cancer accounted for 75.51% and 1.64% of incident cases were identified through death certifications only (DCO%) with mortality to incidence ratio of 0.75. The estimates of new esophageal cancer cases and deaths were 277 thousand and 206 thousand in China, respectively. The crude incidence rate of esophageal cancer in Chinese cancer registration areas was 20.35/10(5) (28.15/10(5) in male, 12.15/10(5) in female), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population were 13.64/10(5) and 13.82/10(5) with the cumulative incidence rate (0-74 age years old) of 1.77%. The esophageal cancer incidence and ASIRC were 13.38/10(5) and 8.74/10(5) in urban areas whereas in rural areas, they were 28.44/10(5) and 19.56/10(5,) respectively. In rural areas, the crude incidence rate of esophageal cancer was 2.13 times higher than that in urban areas, and after age-standardized it remained 2.24 times higher. The esophageal cancer mortality in Chinese cancer registration areas was 15.17/10(5) (20.86/10(5) in male and 9.20/10(5) in female), age-standardized mortality by Chinese standard population (ASMRC) and by world standard population were 9.95/10(5) and 9.98/10(5,) with the cumulative mortality rate (0-74 age years old) of 1.20%. The esophageal cancer mortality and ASMRC were 10.12/10(5) and 6.46/10(5) in urban areas, whereas in rural areas, they were 21.05/10(5) and 14.16/10(5,) respectively. In rural areas, the esophageal cancer mortality and ASMRC were 2.08 and 2.19 times higher than those in urban areas. Esophageal cancer was the sixth common cancer and the fourth leading causes of cancer death, accounting for about 7.52% of all cancer cases and 9.26% of all cancer deaths. Conclusions: Esophageal cancer is one of the most common cancers in China. Screening and early detection are important to reduce the incidence and mortality.

Long-term trends and survival analysis of esophageal and gastric cancer in Yangzhong, 1991-2013.

ObjectiveTo describe the long-term trends of the incidence, mortality and survival of upper digestive tract cancers in a high-risk area of China.MethodsWe extracted esophageal and gastric cancer cases diagnosed from 1991 to 2013 through the Yangzhong Cancer Registry and calculated the crude and age-standardized incidence and mortality rates. Cancer trends were calculated using the Joinpoint Regression Program and were reported using the annual percentage change (APC). The cancer-specific survival rates were evaluated and compared between groups using the Kaplan-Meier method and log-rank test.ResultsThe age-standardized incidence rate of esophageal cancer declined from 107.06 per 100,000 person-years (male: 118.05 per 100,000 person-years; female: 97.42 per 100,000 person-years) in 1991 to 37.04 per 100,000 person-years (male: 46.43 per 100,000 person-years; female: 27.26 per 100,000 person-years) in 2013, with an APC of -2.5% (95% confidence interval (CI): -3.4%, -1.5%) for males and -4.9% (95% CI:-5.8%, -3.9%) for females. The age-standardized incidence rate of gastric cancer was 165.11 per 100,000 person-years (male: 225.39 per 100,000 person-years; female: 113.34 per 100,000 person-years) in 1991 and 53.46 per 100,000 person-years (male: 76.51 per 100,000 person-years; female: 32.43 per 100,000 person-years) in 2013, with the APC of -3.6% (95% CI: -4.5%, -2.7%) for males and -4.8% (95% CI: -5.7%, -3.9%) for females. The median survival time was 3.0 years for patients with esophageal or gastric cancer. Cancer cases detected after 2004 had a better prognosis.ConclusionsThe age-standardized incidence rates of both esophageal and gastric cancer continuously decreased since 1991 through 2013, whereas the mortality rate remained stable before 2004 and significantly declined following the massive endoscopic screening program initiated in 2004. The survival probability of patients with esophageal and gastric cancer has improved obviously in recent decades.

The long-term spatial-temporal trends and burden of esophageal cancer in one high-risk area: A population-registered study in Feicheng, China.

BackgroundFeicheng County is a high-risk area for esophageal cancer in Shandong province, China. It is important to determine the long-term spatio-temporal trends in epidemiological characteristics and the burden of esophageal cancer, especially since the implementation of the national esophageal cancer screening program for early detection and treatment in 2005.MethodsThe data collected in Feicheng County from 2001 to 2012 was extracted from the whole-population cancer registry system. The incidence, mortality, disability-adjusted life years (DALY) and changing trends in esophageal cancer according to age and sex were calculated and described.ResultsThe incidence rate of esophageal cancer in Feicheng was consistently high, and increased significantly for male, but not for female from 2001 to 2012, according to the joinpoint regression analysis. The highest and lowest yearly crude incidence rates were 160.78 and 95.97 per 100000 for males, and 81.36 and 52.17 per 100000 for females. The highest and lowest crude yearly mortality rates were 122.26 and 94.40 per 100000 for males, and 60.75 and 49.35 per 100000for females. Esophageal squamous cell carcinoma was the main pathology type and the tumor location changed significantly from 2001 to 2012. Overall, the DALY remained roughly stable and was estimated as 11.50 for males and 4.90 for females per 1000 people. The burden was mainly caused by premature death. There is an obvious spatial pattern in the distribution of incidence density and burden.ConclusionEsophageal cancer remains a public health issue in Feicheng County with a high incidence, mortality and disease burden. The incidence and burden have obvious spatial heterogeneity, and further studies should be conducted to identify geographical risk factors for precise local prevention and control measures.

Esophageal Cancer and associated Factors among Uzbek-Turkmen and Other Ethnic Groups in the Northern Part of Afghanistan

Background:A high incidence rate of esophageal cancer has been observed in the Northern part of Afghanistan, particularly among those of Uzbek-Turkmen ethnicity. However, there is a paucity of published data from which to compare the prevalence of environmental risk factors for esophageal cancer between Uzbek-Turkmen and other ethnic groups. Thus, we investigated the prevalence of environmental risk factors associated with esophageal cancer in the Northern part of Afghanistan, focusing on ethnicity differences.Methods:This retrospective study covered 168 patients diagnosed with esophageal cancer based on endoscopic findings when attending an outpatient clinic from October 2013 to April 2016. Demographic data and burden of relevant environmental risk factors were compared between Uzbek-Turkmen and other ethnic groups.Results:In the total of 168 patients (108 Uzbek-Turkmen and 60 other ethnicities), males had significantly higher rates of opium use, chewing nass (a mixture of tobacco, ash and lime), and smoking than female patients. The mean age of the Uzbek-Turkmen group was 62.9 years, while that of the other ethnic group cases was 59.1. The prevalence of opium use, chewing nass and hot tea consumption was significantly higher in the Uzbek-Turkmen group.Conclusions:This study showed that there were significant differences in prevalence of opium, nass, and hot tea consumption between Uzbek-Turkmen and the other ethnic group patients with esophageal cancer in the northern part of Afghanistan.

Cancer incidence in Ireland—the possible role of diet, nutrition and lifestyle

This observational ecological study aims to compare Ireland’s age-specific cancer incidence rates (ASRs) with equivalent European and global data and to highlight possible dietary, nutritional and lifestyle contributors to cancer in Ireland. Using the International Agency for Research on Cancer’s (IARC) GLOBOCAN database, Irish ASRs for all-site cancer and for “lifestyle-related” cancers such as those of the colo-rectum, oesophagus, breast, lung and prostate were compared with European and global incidence data. Irish dietary and nutrient intake data were reviewed and evaluated in the context of these cancer incidence data and in relation to the established dietary, nutritional, lifestyle and anthropometric predictors of increased cancer risk previously articulated in the literature. Incidence rates of colorectal, oesophageal, breast, lung, prostate and all-site cancer are higher in Ireland than in most other countries. National nutrition surveys in Ireland indicate that dietary, nutritional, lifestyle and anthropometric risk factors for cancer occur with high frequency in the Irish population. For example, low fruit and vegetable consumption, high red and processed meat intake, low fish intake, low dairy consumption, high saturated fat intake, low folate and vitamin D intakes, and excessive alcohol consumption are all common amongst Irish adults. Our data suggest that unfavourable diet and nutrient intakes prevail in Ireland and that these may contribute to Ireland’s excess cancer burden. These risk factors should be targeted by interventions seeking to sustainably redress Ireland’s high cancer incidence. Such initiatives may provide a template for intervention in other high-risk countries.

Incidence and trend analysis of esophageal cancer in China

Incidence data retrieved from population-based cancer registration were used to analyze the esophageal cancer incidence and trend in China. The results can provide basic information for prevention and control of esophageal cancer. Esophageal cancer incidence data in 2012 were retrieved from the National Central Cancer Registry, nationwide new esophageal cancer cases were estimated using age-specific rate by urban or rural and gender and national population in 2012. Esophageal cancer incidence data from 22 cancer registries were used to analyze the trend during 2000-2011. The estimates of new cases of esophageal cancer were about 286.7 thousand in 2012 in China. The incidence rate was 21.17/10(5,) the age-standardized incidence rates by Chinese standard population and by world population were 14.73/10(5) and 14.93/10(5,) respectively, and the cumulative incidence rate was 1.91%.There was a decreasing trend of incidence rate of esophageal cancer in registration areas of China during 2000-2011 with an average annual percentage change (AAPC) of 0.9% (95%CI: -1.6% to -0.1%), no significant differences were observed in urban area and an increasing trend with AAPC of 1.3% (95%CI: 0.2% to 2.5%) in rural area. After age standardization, the incidence rate was significantly decreased, with AAPC of -4.0% (95%CI: -5.5% to -2.6%) overall, -3.8% (95%CI: -4.9% to -2.7%) in urban and -1.7% (95%CI: -3.0% to -0.4%) in rural areas. Esophageal cancer is one of the most common cancers in China and is an emphasis for cancer control. After effective control of risk factors and development of esophageal cancer screening techniques in high-risk areas for years, esophageal cancer incidence appears to have a significant decreasing trend.

Time trends in the incidence of oesophageal cancer in Asia: Variations across populations and histological types

ObjectiveWe aimed to assess temporal trends in incidence rates of oesophageal cancer in Asian countries. Materials and methodsUsing data from the Cancer Incidence in Five Continents series, we examined the temporal trends in incidence rates of oesophageal cancer by population and histological type in seven Asian countries in 1988–2007. Age-period-cohort analyses estimated the overall annual percentage changes (net drifts) and their 95% confidence intervals (CIs) in incidence rates. ResultsThe age-standardised incidence rate of oesophageal cancer declined in most Asian populations, but remained relatively unchanged in Japan and Israel. The rate of oesophageal squamous cell carcinoma decreased in Hong Kong, Singapore and Israel, but was stable in Japan. The net drifts were statistically significant in men in Hong Kong (−3.4%, 95% CI: −6.1%, −0.7%) and in women in Singapore (−10.1%, 95% CI: −14.4%, −5.5%). The age-standardised incidence rates of oesophageal adenocarcinoma were below 2 and 0.5 per 100 000 in men and women, respectively, across all periods in the all registers containing valid data on histological type. The age-standardised incidence rate of oesophageal adenocarcinoma slightly increased in Japan, Singapore, and Israel, although the net drift was statistically significant only in Israeli men (4.9%, 95% CI: 0.8%, 9.1%). ConclusionThe overall incidence rates of oesophageal cancer declined in most Asian countries, which is due to a decrease in oesophageal squamous cell carcinoma incidence. However, attention needs to be paid to a probable beginning of an increasing incidence of oesophageal adenocarcinoma in Asia.

Updated incidence rates and risk factors of esophageal cancer in Nan'ao Island, a coastal high-risk area in southern China.

Esophageal cancer (EC) is one of the most common cancers in China. The purpose of this study was to investigate the updated incidence rates and risk factors of EC in Nan'ao Island, where the EC incidence rate was chronically the highest in southern China. To calculate the annual incidence rate, data on 338 EC cases from Nan'ao Cancer Registry system diagnosed during 2005-2011 were collected. A case-control study was conducted to explore the EC risk factors. One hundred twenty-five alive EC patients diagnosed during 2005-2011 and 250 controls were enrolled into the case-control study. A pre-test questionnaire on demography, dietary factors, drinking water treatment, and behavioral factors was applied to collect information of all participants. The average EC incidence rates during 2005-2011 were 66.09/105, 94.62/105, 36.83/105 for both genders, males and females, respectively, in Nan'ao Island. The EC incidence rate in males was 2.40- to 4.55-fold higher than that in females in the period from 2006 to 2011 (P < 0.05). Considering the onset age, males tend to be much younger than females and reached peak incidence rate at a younger age (P < 0.05). Drinking water treatment by filter (odds ratio [OR] = 0.28, 95% confidence interval [95% CI] = 0.13-0.58) and fruit consumption (OR = 0.55, 95% CI = 0.32-0.94) reduced the risk for EC. On the contrary, the pickled vegetables consumption (OR = 2.64, 95% CI = 1.46-4.76) and liquor drinking (OR = 2.32, 95% CI = 1.21-4.44) increased the risk for EC. These results may be of importance for future research on EC etiology and prevention strategies.

The incidence and mortality of esophageal cancer and their relationship to development in Asia.

Esophageal cancer is the most common cancer in less developed countries. It is necessary to understand epidemiology of the cancer for planning. The aim of this study was to evaluate the incidence and mortality of esophageal cancer, and its relationship with Human Development Index (HDI) and its components in Asia in 2012. This study was an Ecological study, which conducted based on GLOBOCAN project of WHO for Asian counters. We assess the correlation between standardized incidence rates (SIR) and standardized mortality rates (SMR) of esophageal cancer with HDI and its components with using of SPSS18. A total of 337,698 incidence (70.33% were males and 29.87% females. Sex ratio was 2.37) and 296,734 death (69.45% in men and 30.54% in women. The sex ratio was 2.27) esophageal cancer was recorded in Asian countries in 2012. Five countries with the highest SIR and SMR of esophageal cancer were Turkmenistan, Mongolia and Tajikistan, Bangladesh and China respectively. Correlation between HDI and SIR was -0.211 (P=0.159), in men -0.175 (P=0.244) and in women -0.231 (P=0.123). Also between HDI and SMR -0.250 (P=0.094) in men -0.226 (P=0.131) and in women -0.251 (P=0.037). The incidence of esophageal cancer is more in less developed and developing countries. Statistically significant correlation was not found between standardized incidence and mortality rates of esophageal cancer, and HDI and its dimensions, except for life expectancy at birth.

Esophageal cancer statistics in China, 2011: Estimates based on 177 cancer registries.

Esophageal cancer has been a common cancer in China for many years. Using the most recent data collected from the National Central Cancer Registry, we present estimates of the esophageal cancer burden in China in 2011. Age-specific incidence and mortality rates by gender and area for 18 age groups were calculated based on data from 177 qualified population-based cancer registries. The number of new cases of esophageal cancer and cancer deaths were computed by multiplying these rates by the 2011 population. Crude incidence and mortality rates of esophageal cancer were estimated. The estimated number of new esophageal cancer cases and deaths were 291 238 and 218 957, respectively. The crude incidence and mortality rates for esophageal cancer were 21.62/100 000 and 16.25/100 000, respectively. The age-standardized incidence and mortality rates by world population were 15.83/100 000 and 11.62/100 000, respectively. Both the incidence and mortality rates of esophageal cancer were higher in rural areas than in urban areas, and in men than in women. The age-specific esophageal cancer incidence and mortality rates increased with age. In China, squamous cell cancer was the most common pathological type of the disease. Esophageal cancer remains a major public health issue in China. Primary and secondary prevention are essential for disease control.

Incidence and mortality rate of esophageal cancer has decreased during past 40 years in Hebei Province, China.

Hebei province is located in North of China with of approximately 6% of whole national population. It is known as a high-risk area for esophageal cancer in China and worldwide. The aim of our study was to estimate the esophageal cancer burden and trend in Hebei Province. Eight cancer registries in Hebei Province submitted cancer registry data to the Hebei Provincial Cancer Registry Center. All data were qualified and compiled for cancer statistics in 2011. The pooled data were stratified by gender and age group (0, 1-4, 5-9, 10-14…80+). Incidence and mortality rates were age-standardized to World Segi's population standard and expressed per 100,000 persons. In addition, proportions and cumulative incidence/mortality rates for esophageal cancer were calculated. Esophageal cancer mortality data during the periods 1973-1975, 1990-1992, and 2004-2005 were extracted from the national death surveys. Mortality and incidence rate data from Cixian and Shexian were obtained from population-based cancer registries in each county. The estimated number of newly diagnosed esophageal cancer cases and deaths in 2011 in Hebei Province was 24,318 and 18,226, respectively. The crude incidence rate of esophageal cancer was 33.37/100,000 (males, 42.18/100,000 and females, 24.31/100,000). The age-standardized rate by world standard population (ASRW) was 28.09/100,000, ranking third among all cancers. The esophageal cancer mortality rate was 25.01/100,000 (males, 31.40/100,000 and females, 18.45/100,000), ranking third in deaths among all cancers. The mortality rates of esophageal cancer displayed a significant decreasing trend in Hebei Province from 1973-1975 (ASRW =48.69/100,000) to 2004-2005 (ASRW =28.02/100,000), with a decreased rate of 42.45%. In Cixian, the incidence of esophageal cancer decreased from 250.76/100,000 to 106.74/100,000 in males and from 153.86/100,000 to 75.41/100,000 in females, with annual percentage changes (APC) of 2.13 and 2.16, while the mortality rates declined with an APC of 2.46 for males and 3.10 for females from 1988 to 2011. In Shexian, the incidence rate decreased from 116.90/100,000 to 74.12/100,000 in males and from 46.98/100,000 to 40.64/100,000 in females, while the mortality rates declined, with an APC of 4.89 in males from 2003 to 2011. Although the incidence and mortality rates of esophageal cancer remain high, an obvious decreasing trend has been observed in Hebei Province, as well as in high-risk regions, such as Cixian and Shexian, over the past 40 years.

Application of Bayesian Multilevel Space-Time Models to Study Relative Risk of Esophageal Cancer in Iran 2005-2007 at a County Level.

Reported age standardized incidence rates for esophageal cancer in Iran are 0.88 and 6.15 for females and males, at fifth and the eighth ranks, respectively, of cancers overall. The present study aimed to map relative risk using more realistic and less problematic methods than common estimators. In this ecological investigation, the studied population consisted of all esophageal cancer patients in Iran from 2005 to 2007. The Bayesian multilevel space-time model with three levels of county, province, and time was used to measure the relative risk of esophageal cancer. Analyses were conducted using R package INLA. The total number of registered patients was 7,160. According to the results, the three-level model with adjustment for risk factors of physical activity and smoking had the best fit among all models .The overall temporal trend was significantly increasing. At county level, Ahar, Marand, Salmas, Bojnoord, Saghez, Sarakhs, Shahroud and Torbatejam had the highest relative risks. Physical activity was found to have significant direct association with risk of developing esophageal cancer. Given to great variation across geographical areas, many different factors affect the incidence of esophageal cancer. Conducting further studies at the individual level in areas with high incidence could provide more detailed information on risk factors of esophageal cancer.

Trend of the Esophageal Cancer Incidence in IRAN

Introduction: Cancer is one of the main causes for mortality and morbidity in the world. Identifying epidemiology and the trend of esophageal cancer may be highly effective in related planning. The present study has been carried out with the aim of exploring the morbidity and trend of esophageal cancer in Iran. Methods : The present study is a type of repeated analysis of the existing data. The population of this study consisted of the cancer registry data during the years (2003-2009) in Iran. The direct incidence rate was standard according to the World Health Organization (WHO) population. The incidence trend of this disease in this country was drawn by the means of the STATA software and the significance of the morbidity trend diagram was also derived via WINPEPI software. Results: The results indicated the increasing trend of esophageal cancer up to 2008 while this trend has been dropping during the years 2008-9. The 31914 cases of esophageal cancer which have been recorded throughout the country out of which this rate has been increased from 2759 cases in 2003 to 6210 cases in 2009 so this rate signifies 2 times in morbidity and the recording of cases. During this 7-year career, the maximum incidence rate was related to the Ardabil province with 19.03 per 100’000 cases in 2009 while the minimum incidence rate was related to Chahar Mahal and Bakhtiari and also Booshehr provinces with 0.48 and 0.42% per 1000 cases in 2003, respectively. Conclusion: The incidence rate of esophageal cancer in Iran is increasing, particularly in the northern and northwestern regions of the country. It is recommended to employ screening programs and premature diagnosis in the regions and among high risk populations.

Esophageal Cancer

Esophageal cancers are malignancies that can arise along the entire length of the esophagus, from the cervical inlet to the gastroesophageal junction (GEJ). The most common histologic types are adenocarcinoma and squamous cell carcinoma, which account for almost 95% of esophageal cancers. The location of esophageal cancer varies by histology and strongly influences its behavior and treatment approach. The esophagus is divided into four distinct anatomic regions: the cervical, upper thoracic, midthoracic, and lower thoracic esophagus. Squamous cancers usually occur in the upper or middle esophagus. Adenocarcinomas are more commonly found in the lower third of the esophagus and in the GEJ of the stomach. This review of esophageal cancer addresses the epidemiology, etiology/genetics, pathophysiology and pathogenesis, diagnosis, differential diagnosis, treatment, complications, and prognosis. Figures show Siewert classification, age-standardized esophageal cancer incidence rates by sex and world area, endoscopic images of esophageal tumors, chemotherapy for metastatic esophageal cancer, and a management algorithm for localized esophageal cancer. Tables list hereditary cancer syndromes associated with esophageal cancer, differential diagnosis of dysphagia, physical examination findings in esophageal cancer, differential diagnosis of esophageal lesions seen on endoscopy, and prognosis by stage at diagnosis. This review contains 5 highly rendered figures, 5 tables, and 42 references.

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

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 &gt; 60%. In the U.S., the annual incidence of all gastric cancer subtypes decreased significantly among males and females 65+ (AAPC= -2.4% &amp; -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.

The Impact of Uncertainty in Barrett's Esophagus Progression Rates on Hypothetical Screening and Treatment Decisions.

Estimates for the annual progression rate from Barrett's esophagus (BE) to esophageal adenocarcinoma (EAC) vary widely. In this explorative study, we quantified how this uncertainty affects the estimates of effectiveness and efficiency of screening and treatment for EAC. We developed 3 versions of the University of Washington / Microsimulation Screening Analysis-EAC model. The models differed with respect to the annual progression rate from BE to EAC (0.12% or 0.42%) and the possibility of spontaneous regression of dysplasia (yes or no). All versions of the model were calibrated to the observed Surveillance, Epidemiology, and End Results esophageal cancer incidence rates from 1998 to 2009. To identify the impact of natural history, we estimated the incidence and deaths prevented as well as numbers needed to screen (NNS) and treat (NNT) of a one-time perfect screening at age 65 years that detected all prevalent BE cases, followed by a perfect treatment intervention. Assuming a perfect screening and treatment intervention for all patients with BE, the maximum EAC mortality reduction (64%-66%) and the NNS per death prevented (470-510) were similar across the 3 model versions. However, 3 times more people needed to be treated to prevent 1 death (24 v. 8) in the 0.12% regression model compared with the 0.42% progression model. Restricting treatment to those with dysplasia or only high-grade dysplasia resulted in smaller differences in NNT (2-3 to prevent one EAC case) but wider variation in effectiveness (mortality reduction of 15%-24%). The uncertainty in the natural history of the BE to EAC sequence influenced the estimates of effectiveness and efficiency of BE screening and treatment considerably. This uncertainty could seriously hamper decision making about implementing BE screening and treatment interventions.

Epidemiological Characteristics and Prediction of Esophageal Cancer Mortality in China from 1991 to 2012

To analyze the mortality distribution of esophageal cancer in China from 1991 to 2012, to forecast the mortality in the future five years, and to provide evidence for prevention and treatment of esophageal cancer. Mortality data for esophageal cancer in China from 1991 to 2012 were used to describe its epidemiological characteristics, such as the change of the standardized mortality rate, urban-rural differences, sex and age differences. Trend-surface analysis was used to study the geographical distribution of the mortality. Curve estimation, time series, gray modeling, and joinpoint regression were used to predict the mortality for the next five years in the future. In China, the incidence rate of esophageal cancer from 2007 and the mortality rate of esophageal cancer from 2008 increased yearly, with males at 8.72/105 being higher than females, and the countryside at 15.5/105 being higher than in the city. The mortality rate increased from age 45. Geographical analysis showed the mortality rate increased from southern to eastern China, and from northeast to central China. The incidence rate and the standardized mortality rate of esophageal cancer are rising. The regional disease control for esophageal cancer should be focused on eastern, central and northern regions China, and the key targets for prevention and treatment are rural men more than 45 years old. The mortality of esophageal cancer will rise in the next five years.

Long-term outcomes of endoscopic argon plasma coagulation (APC) therapy for early esophageal cancer and precancerous lesions

To evaluate the long-term outcomes of endoscopic argon plasma coagulation (APC) therapy for early esophageal cancer and precancerous lesions. One-hundred and seventy-one cases with early esophageal cancer (intramucosal carcinoma) and precancerous lesions were treated by APC from 1994 to 2005, and all the cases were followed up. One-hundred and sixty-eight (98.2%) cases were follow-up by endoscopic examination for several times. On average, each patient was endoscopically examined 2.8 times. The follow-up rate was 100%. The precancerous lesion group had 160 patients. They were followed up for 5 years. 11 patients died of causes unrelated to cancer. The lesions developed into esophageal squamous cell carcinoma in five patients ( 2 died and 3 underwent esophagectomy). The remaining 144 cases survived without cancer. In this group, the esophageal cancer incidence rate is only 3.1% (5/160). The early cancer (i.e. intramucosal cancer) group had 11 patients. During the 5-year follow-up period, two patients died of causes unrelated to cancer,six patients had recurrence (4 patients died and 2 patients underwent esophagectomy), and only 3 patients survived without cancer. Therefore, the 5-year survival rate was only 27.3% (3/11). The APC therapy for precancerous lesions of the esophagus is effective and successful. Indications should be carefully considered when treating early esophageal cancer such as intramucosal carcinoma by APC therapy.

High incidence of esophageal cancer in central-western Brazil

To determine the incidence and mortality rates of esophageal cancer in central-western Brazil: Goiânia, Brasília, Cuiabá, and Campo Grande, incidence data for Cuiabá (2000-2005) and Brasília (1999-2002) were obtained from the National Cancer Institute, and data from Goiânia (1995-2008) from the Population-Based Cancer Registry of Goiânia. Mortality data for the cities of central-western Brazil were obtained for the period 1980-2008 from the Ministry of Health. Age-standardized incidence and mortality rates were calculated using the world population of Segi. Mortality trends were assessed with the Joinpoint Regression Program and a P value less than 0.05 was defined as significant. The highest incidence of esophageal cancer among men was in Cuiabá (16.0/100 000); the lowest was in Goiânia (6.5/100 000). Among women, the incidence rates were similar in Brasília and Cuiabá, but in Goiânia, the incidence declined. There was a significant increase in mortality among men in Cuiabá (2.4%, P=0.03) and Campo Grande (1.2%, P=0.05), and in women (1.6%, P=0.04) in Goiânia. Mortality by age group increased significantly in Campo Grande by 1.9% for men aged at least 50 years and in Goiânia by 2.7% among women aged at least 50 years; the mortality decreased in Goiânia by 2.2% for women aged less than 50 years. The incidence of esophageal cancer in Brasília and Cuiabá was similar to that of southern Brazil in some periods. There was an increase in mortality trends for men in Cuiabá and Campo Grande, and for women in Goiânia.