Trends in incidence and survival of esophageal cancer in Korea: Analysis of the Korea Central Cancer Registry Database

Abstract

Background and aim: The diagnostic and therapeutic modalities of esophageal cancer have recently improved in Asia, and its prognosis is expected to change. This study provides a population-based report on the epidemiology of esophageal cancer in Korea.

Methods: Cancer incidence data from 1999 to 2013 were obtained from the Korea Central Cancer Registry, covering the entire population. Age-standardized incidence rates and annual percent changes were calculated according to subsites and histological types. Five-year relative survival rates were estimated for cases diagnosed between 1993 and 2013. Relative excess rates were compared between patients diagnosed from 2009 to 2013 and 2006 to 2008.

Results: The age-standardized incidence rates decreased from 8.8 per 100 000 populations in 1999 to 5.9 in 2013 with an annual percent change of -2.6% in men and -2.2% in women. The most common histological type was squamous cell carcinoma, accounting for 90.2% of all esophageal cancers in 2013, followed by adenocarcinomas (3.1%), and their incidences decreased. The proportion of localized and regional cancer tended to increase compared with that of distant cancer. Five-year relative survival of squamous cell carcinoma improved from 12.1% (1993-1995) to 34.6% (2009-2013). Relative excess rate was 0.72 (95% confidence interval 0.65-0.80) in localized stage and 0.88 (95% confidence interval, 0.82-0.95) in regional stage comparing patients diagnosed from 2009 to 2013 and 2006 to 2008.

Conclusions: The incidence of esophageal cancer has decreased in Korea for the past 15 years, and 5-year survival rates have improved significantly. These increases may be attributable to more effective detection of early-stage disease.

Keywords: cancer incidence; cancer registry; esophageal cancer; survival rates.

Figure 1

Age‐standardized incidence rates per 100 000 people for esophageal cancer by sex and histological subtypes, 1999–2013. (a) Total, (b) men, and (c) women. , Overall; , Squamous cell carcinoma; , Adenocarcinoma; , Other specified; , Unspecified. [Color figure can be viewed at wileyonlinelibrary.com]

Figure 2

Relative survival rates (%) of 1, 3, and 5 years of patients with esophageal cancer by period of diagnosis according to Surveillance, Epidemiology, and End Results stage. , 1‐year; , 3‐year; , 5‐year. [Color figure can be viewed at wileyonlinelibrary.com]