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. 2022 Jan 6;14(2):275.
doi: 10.3390/cancers14020275.

Gastrointestinal Adenocarcinoma Incidence and Survival Trends in South Australia, 1990-2017

Dominique Schell  1 , Shahid Ullah  1 , Mark E Brooke-Smith  2 , Paul Hollington  1   2 , Marina Yeow  2 , Christos S Karapetis  1   3   4 , David I Watson  1   2   3 , Stephen J Pandol  5 , Claire T Roberts  1   3 , Savio G Barreto  1   2   3
Affiliations

Gastrointestinal Adenocarcinoma Incidence and Survival Trends in South Australia, 1990-2017

Dominique Schell et al. Cancers (Basel). .

Abstract

Background & aims: Globally, there has been a concerning rise in the incidence of young-onset cancers. The aim of this study was to provide trends in the incidence and survival of gastrointestinal adenocarcinomas (oesophagus, stomach, pancreas, and colorectal) in South Australia over a 27-year period.

Methods: This is a cross-sectional analysis of a prospective longitudinal database including all cases of gastrointestinal adenocarcinomas prospectively reported to the South Australian (State) Cancer Registry from 1990 to 2017.

Results: A total of 28,566 patients diagnosed with oesophageal, stomach, pancreatic, or colorectal adenocarcinoma between 1990 and 2017 were included in the study. While the overall incidence for gastrointestinal adenocarcinomas in individuals >50 years has decreased since 2000 (IRR of 0.97 (95% CI 0.94-1.00; p = 0.06)) compared to 1990-1999, the rate amongst individuals aged 18-50 has significantly increased (IRR 1.41 (95% CI 1.27-1.57; p < 0.001)) during the same reference time period. Although noted in both sexes, the rate of increase in incidence was significantly greater in males (11.5 to 19.7/100,000; p < 0.001). The overall survival from adenocarcinomas across all subsites improved in the >50-year cohort in the last decade (HR 0.89 (95% CI 0.86-0.93; p < 0.001)) compared to 1990-1999. In individuals aged 18-50 years, there has only been a significant improvement in survival for colorectal cancer (HR 0.82 (95% CI 0.68-0.99; p < 0.04)), but not the other subsites. A lower overall survival was noted for males in both age cohorts (18-50 years-HR 1.24 (95% CI 1.09-1.13; p < 0.01) and >50 years-HR 1.13 (95% CI 1.10-1.16; p < 0.001), respectively) compared to females.

Conclusions: This study from South Australia demonstrates a significant increase in young-onset gastrointestinal adenocarcinomas over the last 28 years, with a greater increase in the male sex. The only significant improvement in survival in this cohort has been noted in colorectal cancer patients.

Keywords: colon; morbidity; mortality; outcomes; pancreas; stomach.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Trend in incidence rates by sex and era between two age groups across cancer sites 1990–2017 (n = 28,566).
Figure 2
Figure 2
Incidence rate ratios (IRR) and 95% CI (Poisson regression model) for sex and era by primary sites between two age groups (n = 28,566).
Figure 3
Figure 3
Hazard ratios (HR) and 95% CI (Cox proportional hazard model) for sex and era by primary sites between two age groups (n = 27,855).
See this image and copyright information in PMC

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