Journal of the National Cancer Institute Advance Access originally published online on August 11, 2008
JNCI Journal of the National Cancer Institute 2008 100(16):1184-1187; doi:10.1093/jnci/djn211
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Published by Oxford University Press 2008.
Incidence of Adenocarcinoma of the Esophagus Among White Americans by Sex, Stage, and Age
Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (LMB, SSD, W-HC); RTI International, Rockville, MD (LMB)
Correspondence to: Linda Morris Brown, MPH, DrPH, RTI International, 6110 Executive Blvd, Suite 902, Rockville, MD 20852-3907 (email: lindabrown{at}rti.org).
Rapid increases in the incidence of adenocarcinoma of the esophagus have been reported among white men. We further explored the temporal patterns of this disease among white individuals by sex, stage, and age by use of data from the Surveillance, Epidemiology, and End Results program. We identified 22 759 patients from January 1, 1975, through December 31, 2004, with esophageal cancer, of whom 9526 were diagnosed with adenocarcinoma of the esophagus. Among white men, increases in the incidence of esophageal cancer were largely attributed to a 463% increase in the incidence of adenocarcinoma over this time period, from 1.01 per 100 000 person-years (95% confidence interval [CI] = 0.90 to 1.13) in 1975–1979 to 5.69 per 100 000 person-years (95% CI = 5.47 to 5.91) in 2000–2004. A similar rapid increase was also apparent among white women, among whom the adenocarcinoma rate increased 335%, from 0.17 (95% CI = 0.13 to 0.21) to 0.74 per 100 000 person-years (95% CI = 0.67 to 0.81), over the same time period. Adenocarcinoma rates rose among white men and women in all stage and age groups, indicating that these increases are real and not an artifact of surveillance.
| CONTEXT AND CAVEATS Prior knowledge Rapid increases in the incidence of adenocarcinoma of the esophagus have been reported among white men. Study design Registry study in which data from the Surveillance, Epidemiology, and End Results program from January 1, 1975, through December 31, 2004, was used to explore the temporal patterns of this disease among white individuals by sex, stage, and age. Contribution Adenocarcinoma incidence rates rose from 1975 through 2004 among white men and women in all stage and age groups. The incidence of adenocarcinoma among white men increased 463%, from 1.01 per 100 000 person-years in 1975–1979 to 5.69 per 100 000 person-years in 2000–2004. A similar rapid increase was also apparent among white women, with an increased incidence of 335% from 0.17 per 100 000 person-years to 0.74 per 100 000 person-years. Implications Because the increases in incidence are independent of stage and age group, they appear to be real and not an artifact of surveillance. Limitations Cases of adenocarcinoma may have been missed or misclassified. Data for the most recent years may have been underreported. Pathological diagnoses were not reviewed centrally. From the Editors
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Manuscript received February 21, 2008; revised May 22, 2008; accepted May 23, 2008.
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J Natl Cancer Inst 2008 100: 1119.