Trends and projections in adenocarcinoma and squamous cell carcinoma of the oesophagus in England from 1971 to 2037

Abstract

Background: The aim of this study was to assess the incidence and trends of oesophageal adenocarcinomas (OACs) and squamous cell carcinomas (OSCCs) in England from 1971 to 2037.

Methods: Data on 220,026 oesophageal cancers diagnosed in England between 1971 and 2013 were extracted. Multiple imputation was used to predict morphology data were missing. Incidence rates were modelled and extrapolated to 2037 using age-period-cohort models.

Results: The OAC age-standardised incidence rate (ASRs) increase was greatest from 1972 to 1992 (from 4.8 to 12.3 for men and 1.1 to 3 per 100,000 for women) and slowed from 1992 to 2012 (with an increase to 17 for men and 3.8 per 100,000 for women). OSCCs rates decreased from 7.5 to 4.9 from 1972 to 2012 for men. For women, ASRs increased from 5.5 to 5.9 between 1972 and 1992 and then decreased to 4.7 per 100,000 until 2012. Rates until 2032 are predicted to stay stable for OACs and further decrease for OSCCs.

Conclusions: Imputing missing morphology allowed accurate and up-to-date estimates of trends and projections. We observed a slowing down of the increase in OAC ASRs and an overall decrease in OSCC ASRs.

Fig. 1

Incidence rates for all oesophageal cancers combined and OACs and OSCCs separately for men and women in England (log scale). a Annual and modelled incidence rates of all recorded malignant oesophageal cancers from 1971 to 2013. b Annual and modelled OAC incidence rates including cancers with estimated morphology for men and women from 1971 to 2013 and projected rates until 2037. c Annual and modelled OSCC incidence rates including cancers with estimated morphology for men and women from 1971 to 2013 and projected rates until 2037. Dots / triangles represent observed rates; lines represent modelled rates using the APC model. ASR age-standardised incidence rates, ESP European standard population, OAC adenocarcinoma, OSCC squamous cell carcinoma

Fig. 2

Estimated and projected incidence rates for different age ranges in men and women from 1971 to 2037 (log scale) based on an APC model. a OACs; b OSCCs; Dots represent observed + imputed rates; lines represent modelled rates using the APC model. Age groups as described in the figure legend

Fig. 3

Estimated and projected incidence rates using different models for OACs and OSCCs for men and women in England from 1971 to 2037 (log scale). a OAC: Projections using AP or APC models. Small dashed line, estimated rates based on an AP model with the linear increase (drift) as the cohort effect; large dashed line, AP model with the linear increase (drift) as the period effect; solid line, APC model. b OSCC: Solid line, projections using the APC model; Small dashed line, estimated rates based on an age drift (AD)