Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Jan;20(1):183-6.
doi: 10.1158/1055-9965.EPI-10-0802. Epub 2010 Dec 2.

Dating the rise of esophageal adenocarcinoma: analysis of Connecticut Tumor Registry data, 1940-2007

Affiliations

Dating the rise of esophageal adenocarcinoma: analysis of Connecticut Tumor Registry data, 1940-2007

Julian A Abrams et al. Cancer Epidemiol Biomarkers Prev. 2011 Jan.

Abstract

Background: The timing of onset of the rise in incidence of esophageal adenocarcinoma (EAC) has not been clearly defined, and doing so may provide clues with regard to exposures associated with the changed epidemiology of this malignancy. We therefore aimed to investigate historical trends in the incidence of EAC and other upper gastrointestinal malignancies.

Methods: We did a population-based study using Connecticut Tumor Registry (1940-2007) and Surveillance, Epidemiology, and End Results (SEER; 1973-2007) data. Age-adjusted incidence rates (per 100,000 person-years) were calculated for EAC and other upper gastrointestinal malignancies.

Results: The incidence of EAC remained relatively constant until 1965-69, and then rose from 0.41 (95%CI, 0.26-0.56) to 1.31 (95%CI 1.07-1.54) in 1978-82 and 5.31 (95%CI 4.89-5.73) in 2003-07. The incidence of gastric cardia cancer began to rise in the 1950s and plateaued in the 1990s. The incidence of esophageal squamous cell carcinoma began to decrease around 1980. The trends from Connecticut Tumor Registry data closely mirrored those from SEER data.

Conclusions: The incidence of EAC began to rise in the late 1960s, predating the rise in obesity by a decade. Reduced infection rates of Helicobacter pylori, changes in microbiome, or other exposures may have contributed to the changed epidemiology of this malignancy.

Impact: Analysis of historical data of trends in EAC incidence implicate a change in environmental factors from the mid-20th century as primarily responsible for the initial rise in EAC incidence, predating the rise in obesity prevalence in the United States by over a decade.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Age-adjusted incidence of esophageal adenocarcinoma (EAC), esophageal squamous cell cancer (ESCC), gastric cardia cancer (Cardia GC), and gastric non-cardia cancer (Non-Cardia GC), Connecticut 1940–2007. Age-adjusted incidence of EAC from SEER data also shown (EAC (SEER)). (note: y-axis scale is logarithmic)
Figure 2
Figure 2
Schematic of potential historical factors responsible for the observed rise in incidence of esophageal adenocarcinoma. (BE, Barrett’s esophagus; GERD, gastro-esophageal reflux disease)

Similar articles

Cited by

References

    1. Brown LM, Devesa SS, Chow WH. Incidence of adenocarcinoma of the esophagus among white Americans by sex, stage, and age. Journal of the National Cancer Institute. 2008;100:1184–1187. - PMC - PubMed
    1. Wu H, Rusiecki JA, Zhu K, Potter J, Devesa SS. Stomach carcinoma incidence patterns in the United States by histologic type and anatomic site. Cancer Epidemiol Biomarkers Prev. 2009;18:1945–1952. - PMC - PubMed
    1. Zheng T, Mayne ST, Holford TR, et al. Time trend and age-period-cohort effects on incidence of esophageal cancer in Connecticut, 1935–89. Cancer Causes Control. 1992;3:481–492. - PubMed
    1. Whiteman DC, Sadeghi S, Pandeya N, et al. Combined effects of obesity, acid reflux and smoking on the risk of adenocarcinomas of the oesophagus. Gut. 2008;57:173–180. - PubMed
    1. Islami F, Kamangar F. Helicobacter pylori and esophageal cancer risk: a meta-analysis. Cancer Prev Res (Phila) 2008;1:329–338. - PMC - PubMed

Publication types