Changing pattern of esophageal cancer incidence in New Mexico: a 30-year evaluation

Abstract

Background and aim: The incidence of esophageal adenocarcinoma has increased over the last 30 years, especially in non-Hispanic whites (nHw). Recent work indicates an increase in Hispanic Americans (HA). It is important to understand the effect of ethnicity on cancer occurrence over a prolonged interval.

Methods: We searched the New Mexico Tumor Registry for all cases of esophageal cancer from 1 January 1973 to 31 December 2002. Inclusion criteria were histologic diagnosis of adenocarcinoma or squamous cell carcinoma, ethnicity and gender. Incidence rates for both were compared among ethnic groups in 5-year intervals.

Results: Nine hundred eighty-eight patients met the criteria. Esophageal adenocarcinoma incidence rates/100,000 population increased significantly over 30 years; 1973-1977, 0.4 cases; 1978-1982, 0.4 cases; 1983-1987, 0.6 cases; 1988-1992, 1.2 cases, 1993-1997, 1.6 cases and 1998-2002, 2.2 cases; P < 0.001. Squamous cell carcinoma incidence rates remained unchanged during the interval. In nHw and HA, adenocarcinoma incidence rates increased significantly during the study period. In all minority groups, squamous cell carcinoma remained the major type.

Conclusions: Esophageal adenocarcinoma incidence among nHw and HA increased from 1973 to 2002 in New Mexico. Squamous cell carcinoma remains predominant in minorities. Ethnicity may influence the histology or indicate an increased risk for certain types of esophageal cancer.

Fig. 1

Total population and ethnic incidence rates of esophageal adenocarcinoma in New Mexico. Total cases of the esophageal adenocarcinoma increased significantly over the 30-year period: 1973–1977, 0.4 cases per 100,000; 1978–1982, 0.4 cases per 100,000; 1983–1987, 0.6 cases per 100,000; 1988–1992, 1.2 cases per 100,000; 1992–1997, 1.6 cases per 100,000; 1998–2002, 2.2 cases per 100,000 (P < 0.001). Incidence rates increased over time in the non-Hispanic white, Hispanic and Native American populations. The increase seen in non-Hispanic whites and Hispanic Americans achieved statistical significance (P < 0.001 for both groups)

Fig. 2

Total and ethnic incidence rates of esophageal squamous cell carcinoma in New Mexico. Incidence rates did not vary significantly among the total population or between ethnic groups over time