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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(02): E218-E226
DOI: 10.1055/a-2221-7974
Original article

Trends in prevalence of esophageal adenocarcinoma: Findings from a statewide database of over 6 million patients

Bashar Qumseya 
1   Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, United States (Ringgold ID: RIN3463)
,
Shuang Yang
2   Division of Gastroenterology, University of Florida, GAINESVILLE, United States (Ringgold ID: RIN3463)
,
Yi Guo
3   Department of Health Outcomes and Biomedical Informatics, University of Florida, GAINESVILLE, United States (Ringgold ID: RIN3463)
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Abstract

Esophageal cancer (EC) is a leading cause of cancer-related death in the west [1]. Esophageal squamous cell carcinoma (SCC) is the most common type of EC worldwide. However, in Western countries, including the United States, esophageal adenocarcinoma (EAC) is the most common [2]. EAC is most common in the lower esophagus whereas SCC is most common in the middle and upper esophagus [3]. The incidence of EAC has increased dramatically in western countries over the past few decades. [2] [3] The exact reason for this rise in EAC has not been clearly understood. However, an increase in the prevalence of EAC risk factors is postulated as a potential explanation [4]. Although there are many identifiable EAC risk factors, including gastroesophageal reflux disease (GERD), obesity, male sex, White race, and smoking [5] [6] [7], Barrett’s esophagus (BE) remains the major precursor lesion of esophageal adenocarcinoma. BE develops when there is a change in the normal squamous lining of the esophageal mucosa into intestinal metaplasia [8] [9]. The incidence has also increased in the population over the past few decades [10] [11]. There is a well-described progression within BE from non-dysplastic BE (NDBE), low-grade dysplasia (LGD), high-grade dysplasia (HGD), intramucosal carcinoma (IMC), to invasive EAC [12] [13]. Recent data suggest that the increased incidence of EAC may have plateaued [1]. However, we questioned whether the prevalence of EAC is still increasing, especially at younger ages in lieu of recent trends showing an increase in the prevalence of colorectal cancer in younger patients. These findings resulted in a lowering of the colorectal cancer screening age cutoff to 45 years from 50 years [14] [15] [16]. Therefore, we aimed to assess the time trends in the prevalence and incidence of EAC and some of its risk factors in a large population of patients in Florida and to assess these trends based on age categories. We hypothesized that the prevalence of EAC and BE has increased over time at younger age groups.

Keywords

Reflux disease - Barrett's and adenocarcinoma - Epidemiology

Supplementary Material



Publication History

Received: 27 September 2023

Accepted after revision: 01 December 2023

Accepted Manuscript online:
04 December 2023

Article published online:
15 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Islami F, Ward EM, Sung H. et al. Annual Report to the Nation on the Status of Cancer, Part 1: National Cancer Statistics. J Natl Cancer Inst 2021; 113: 1648-1669
    CrossrefPubMedSearch in Google Scholar
  • 2 Njei B, McCarty TR, Birk JW. Trends in esophageal cancer survival in United States adults from 1973 to 2009: A SEER database analysis. J Gastroenterol Hepatol 2016; 31: 1141-1146
    CrossrefPubMedSearch in Google Scholar
  • 3 Then EO, Lopez M, Saleem S. et al. Esophageal cancer: an updated surveillance epidemiology and end results database analysis. World J Oncol 2020; 11: 55-64
    CrossrefPubMedSearch in Google Scholar
  • 4 Chai J, Jamal MM. Esophageal malignancy: a growing concern. World J Gastroenterol 2012; 18: 6521-6526
    CrossrefPubMedSearch in Google Scholar
  • 5 Qumseya BJ, Bukannan A, Gendy S. et al. Systematic review and meta-analysis of prevalence and risk factors for Barrett's esophagus. Gastrointest Endosc 2019; 90: 707-717 e701
    CrossrefPubMedSearch in Google Scholar
  • 6 Qumseya BJ, Wolfsen C, Wang Y. et al. Factors associated with increased bleeding post-endoscopic mucosal resection. J Dig Dis 2013; 14: 140-146
    CrossrefPubMedSearch in Google Scholar
  • 7 van Blankenstein M, Looman CW, Johnston BJ. et al. Age and sex distribution of the prevalence of Barrett's esophagus found in a primary referral endoscopy center. Am J Gastroenterol 2005; 100: 568-576
    CrossrefPubMedSearch in Google Scholar
  • 8 Lenglinger J, Riegler M, Cosentini E. et al. Review on the annual cancer risk of Barrett's esophagus in persons with symptoms of gastroesophageal reflux disease. Anticancer Res 2012; 32: 5465-5473
    PubMedSearch in Google Scholar
  • 9 Kestens C, Offerhaus GJ, van Baal JW. et al. Patients With barrett's esophagus and persistent low-grade dysplasia have an increased risk for high-grade dysplasia and cancer. Clin Gastroenterol Hepatol 2016; 14: 956-962 e951
    CrossrefPubMedSearch in Google Scholar
  • 10 Conio M, Cameron AJ, Romero Y. et al. Secular trends in the epidemiology and outcome of Barrett's oesophagus in Olmsted County, Minnesota. Gut 2001; 48: 304-309
    CrossrefPubMedSearch in Google Scholar
  • 11 van Soest EM, Dieleman JP, Siersema PD. et al. Increasing incidence of Barrett's oesophagus in the general population. Gut 2005; 54: 1062-1066
    CrossrefPubMedSearch in Google Scholar
  • 12 den Hoed CM, van Blankenstein M, Dees J. et al. The minimal incubation period from the onset of Barrett's oesophagus to symptomatic adenocarcinoma. Br J Cancer 2011; 105: 200-205
    CrossrefPubMedSearch in Google Scholar
  • 13 Qumseya BJ, Wani S, Gendy S. et al. Disease progression in Barrett's low-grade dysplasia with radiofrequency ablation compared with surveillance: systematic review and meta-analysis. Am J Gastroenterol 2017; 112: 849-865
    CrossrefPubMedSearch in Google Scholar
  • 14 Shaukat A, Kahi CJ, Burke CA. et al. ACG Clinical Guidelines: Colorectal Cancer Screening 2021. Am J Gastroenterol 2021; 116: 458-479
    CrossrefPubMedSearch in Google Scholar
  • 15 Hussan H, Patel A, Le Roux M. et al. Rising incidence of colorectal cancer in young adults corresponds with increasing surgical resections in obese patients. Clin Transl Gastroenterol 2020; 11: e00160
    CrossrefPubMedSearch in Google Scholar
  • 16 Loomans-Kropp HA, Umar A. Increasing incidence of colorectal cancer in young adults. J Cancer Epidemiol 2019; 2019: 9841295
    CrossrefPubMedSearch in Google Scholar
  • 17 Hogan WR, Shenkman EA, Robinson T. et al. The OneFlorida Data Trust: a centralized, translational research data infrastructure of statewide scope. J Am Med Inform Assoc 2022; 29: 686-693
    CrossrefPubMedSearch in Google Scholar
  • 18 National Cancer Institue Surveillance, Epidemiology, and End Results Program. Cancer Stat Facts: Esophageal cancer. https://seer.cancer.gov/statfacts/html/esoph.html
    PubMed
  • 19 Torre LA, Bray F, Siegel RL. et al. Global cancer statistics, 2012. CA Cancer J Clin 2015; 65: 87-108
    CrossrefPubMedSearch in Google Scholar
  • 20 Dharwadkar P, Lai A, Brown G. et al. Decreasing Rates of Gastrointestinal Cancer at a Veterans Affairs Hospital Between 1994 to 2013: 1000. American Journal of Gastroenterology 2016; 111: S436
    CrossrefPubMedSearch in Google Scholar
  • 21 Xie Y, Shi L, He X. et al. Gastrointestinal cancers in China, the USA, and Europe. Gastroenterol Rep (Oxf) 2021; 9: 91-104
    CrossrefPubMedSearch in Google Scholar
  • 22 Pera M, Manterola C, Vidal O. et al. Epidemiology of esophageal adenocarcinoma. J Surg Oncol 2005; 92: 151-159
    CrossrefPubMedSearch in Google Scholar
  • 23 Patel N, Benipal B. Incidence of esophageal cancer in the United States from 2001–2015: A United States cancer statistics analysis of 50 states . Cureus 2018; 10: e3709
    PubMedSearch in Google Scholar
  • 24 American Cancer Society. Key Statistics for Esophageal Cancer. https://www.cancer.org/cancer/esophagus-cancer/about/key-statistics.html#references
    PubMed
  • 25 Wang Z, Graham DY, Khan A. et al. Incidence of gastric cancer in the USA during 1999 to 2013: a 50-state analysis. Int J Epidemiol 2018; 47: 966-975
    CrossrefPubMedSearch in Google Scholar
  • 26 Troeung L, Sodhi-Berry N, Martini A. et al. Increasing Incidence of colorectal cancer in adolescents and young adults aged 15–39 years in Western Australia 1982–2007: examination of colonoscopy history. Front Public Health 2017; 5: 179
    CrossrefPubMedSearch in Google Scholar
  • 27 Klaver E, Bureo Gonzalez A, Mostafavi N. et al. Barrett's esophagus surveillance in a prospective Dutch multi-center community-based cohort of 985 patients demonstrates low risk of neoplastic progression. United Europ Gastroenterol J 2021; 9: 929-937
    CrossrefPubMedSearch in Google Scholar
  • 28 Rugge M, Fassan M, Cavallin F. et al. Risk of malignant progression in Barrett's esophagus patients: results from a large population-based study. J Natl Cancer Inst 2012; 104: 1771-1772
    CrossrefPubMedSearch in Google Scholar
  • 29 Codipilly DC, Chandar AK, Singh S. et al. The Effect of endoscopic surveillance in patients with Barrett's esophagus: a systematic review and meta-analysis. Gastroenterology 2018; 154: 2068-2086 e2065
    CrossrefPubMedSearch in Google Scholar
  • 30 Qumseya B, Sultan S. American Society of Gastrointestinal Endoscopy Standards Of Practice Committee. et al. ASGE guideline on screening and surveillance of Barrett's esophagus. Gastrointest Endosc 2019; 90: 335-359 e332
    CrossrefPubMedSearch in Google Scholar
  • 31 Shaheen NJ, Falk GW, Iyer PG. et al. Diagnosis and management of Barrett's Esophagus: An updated ACG guideline. Am J Gastroenterol 2022; 117: 559-587
    Search in Google Scholar
  • 32 Muthusamy VR, Wani S, Gyawali CP. et al. AGA clinical practice update on new technology and innovation for surveillance and screening in Barrett's esophagus: expert review. Clin Gastroenterol Hepatol 2022;
    CrossrefPubMedSearch in Google Scholar
  • 33 Stoffel EM, Murphy CC. Epidemiology and mechanisms of the increasing incidence of colon and rectal cancers in young adults. Gastroenterology 2020; 158: 341-353
    CrossrefPubMedSearch in Google Scholar
  • 34 Schlottmann F, Dreifuss NH, Patti MG. Obesity and esophageal cancer: GERD, Barrett s esophagus, and molecular carcinogenic pathways. Expert Rev Gastroenterol Hepatol 2020; 14: 425-433
    CrossrefPubMedSearch in Google Scholar
  • 35 Cho JH, Shin CM, Han KD. et al. Abdominal obesity increases risk for esophageal cancer: a nationwide population-based cohort study of South Korea. J Gastroenterol 2020; 55: 307-316
    CrossrefPubMedSearch in Google Scholar