New Study Confirms Increased Incidence of Adenocarcinoma of the Esophagus in White Americans
Researchers from the National Institutes of Health have reported that between 1975 and 2004, the incidence of adenocarcinoma of the esophagus increased by 463% in White males and 335% in White females. The details of this study appeared in an early online publication in the Journal of the National Cancer Institute on August 11, 2008.
The esophagus is the tube that connects the back of the mouth to the stomach. Esophageal cancer is relatively common and is very deadly. It 1998 there were approximately 12,300 new cases of esophageal cancer diagnosed in the United States and nearly 12,000 esophageal cancer deaths, making esophageal cancer one of the most deadly of all cancers. Most cancers of the upper two-thirds of the esophagus arise from a type of cell called squamous cells. Cancers of the lower esophagus most often arise from cells called columnar epithelium and are referred to as adenocarcinomas of the esophagus.
In the recent past, squamous cell cancers made up more than 80% of all esophageal cancers. Over the past two decades, there has been a dramatic increase in the incidence of adenocarcinomas, which now account for one-third to one-half of all esophageal cancers. Thus, the recent increase in the overall incidence of esophageal cancer is almost entirely due to the increase in adenocarcinomas.
Environmental factors such as smoking, drinking, and obesity have long been known to be associated with an increased incidence of gastric and esophageal cancers. It is also well recognized that gastroesophageal reflux plays a role in causing esophageal cancer.
The current study is the best documentation of the increased incidence of adenocarcinomas of the esophagus. Using data from the Surveillance, Epidemiology, and End Results (SEER) program, these authors compared the incidence of adenocarcinoma of the esophagus in the 1975-1979 period with the most recent data from 2000-2004.
- Between 1975 and 2004 the incidence increased 463% among White males and 335% among White females.
- The incidence rose in all age and stage groups and was not due to increased surveillance.
The researchers concluded that the incidence of esophageal cancer has risen significantly over the past 30 years, specifically adenocarcinoma of the esophagus. Although the exact causes of the increased incidence are unclear, a significant factor may be the increasing obesity of the U.S. population.
Brown LM, Devesa SS, Chow W-H. Incidence of adenocarcinoma of the esophagus among white Americans by sex, stage and age. Journal of the National Cancer Institute [early online publication]. 2008; on August 11.