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
. 2023 Aug 1;6(8):e2329497.
doi: 10.1001/jamanetworkopen.2023.29497.

Trends in Epidemiology of Esophageal Cancer in the US, 1975-2018

Gladys M Rodriguez  1 , Dylan DePuy  2 , Mayada Aljehani  2 , Jeffrey Bien  3 , Jerry S H Lee  2   4 , David H Wang  5   6 , Albert Y Lin  7   8
Affiliations

Trends in Epidemiology of Esophageal Cancer in the US, 1975-2018

Gladys M Rodriguez et al. JAMA Netw Open. .

Abstract

Importance: Esophageal cancer (EC) is the 7th most common cancer worldwide and 14th in the US. More data are needed to study the changing incidence patterns of its 2 primary histologic subtypes, squamous cell carcinoma of the esophagus (SCE) and adenocarcinoma of the esophagus (ACE).

Objective: To examine temporal trends in incidence rates of EC, ACE, and SCE from 1975 through 2018.

Design, setting, and participants: In this population-based cross-sectional study, data were derived from 9 Surveillance, Epidemiology, and End Results (SEER) registries from January 1975 through December 2018 and from all 21 registries for January 2000 through December 2018 for patients with a diagnosis of EC from 1975 through 2018 (International Classification of Disease-Oncology, Third Edition codes). Age-adjusted incidence rates (AAIRs) of EC, ACE, and SCE were calculated. The timing and magnitude of the annual percentage change (APC) in incidence were examined using Joinpoint regression analyses. Data analysis was started in 2021 and updated and completed in 2023.

Main outcome and measures: The APC for age-adjusted EC incidence rates as stratified by histology, anatomical location, stage, sex, age, race and ethnicity, and geographic region.

Results: A total of 47 648 patients with a diagnosis of EC were retained for analysis. These included 22 419 (47.1%) with a diagnosis of SCE, 22 217 (46.6%) with ACE, and 3012 (6.3%) with other subtypes. The AAIR for EC changed from 4.14 per 100 000 population in 1975 to 4.18 in 2018, AAIRs of SCE declined from 3.06 in 1975 to 1.15 in 2018 as well as for ACE, and AAIRs increased from 0.42 in 1975 to 2.78 in 2018. From 1975 through 2004, EC incidence significantly increased (APC, 0.53; 95% CI, 0.4 to 0.7) but significantly decreased (APC, -1.03; 95% CI, -1.3 to -0.7) from then until 2018. The APC of SCE significantly continued to decline (-2.80, 95% CI, -3.0 to -2.6), and ACE increased from 2000 to 2006 (APC, 2.51; 95% CI, 1.0 to 4.0) but has since stabilized from 2006 to 2018.

Conclusions and relevance: The results of this cross-sectional study suggest that the incidence of EC modestly declined since 2004 and that the incidence of SCE continued to decline while the incidence rate of ACE plateaued for more than a decade. Understanding factors associated with plateaued rates of ACE may help inform public health interventions.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Lin reported grants from US Department of Defense during the conduct of the study. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Incidence of and Percentage Share of Incidence of Esophageal Cancer (EC), Adenocarcinoma of Esophagus (ACE), Squamous Carcinoma of Esophagus (SCE), and Other Subtypes
Figure 2.
Figure 2.. Joinpoint Analysis of Overall Esophageal Cancer (EC), Adenocarcinoma of Esophagus (ACE), and Squamous Carcinoma of Esophagus (SCE) Incidence
APC indicates annual percentage change; SEER, Surveillance, Epidemiology, and End Results. aP <.05.
Figure 3.
Figure 3.. Joinpoint Analysis of Esophageal Cancer (EC), Adenocarcinoma of Esophagus (ACE), and Squamous Carcinoma of Esophagus (SCE) Incidence by Stage
APC indicates annual percentage change. aP <.05.
Figure 4.
Figure 4.. Esophageal Cancer (EC), Adenocarcinoma of Esophagus (ACE), and Squamous Carcinoma of Esophagus (SCE) Incidence by Anatomical Site of Origin
APC indicates annual percentage change. aP <.05.
Figure 5.
Figure 5.. Joinpoint Analysis of Esophageal Cancer (EC), Adenocarcinoma of Esophagus (ACE), and Squamous Carcinoma of Esophagus (SCE) Incidence by Census Region
APC indicates annual percentage change. aP <.05.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Morgan E, Soerjomataram I, Rumgay H, et al. . The global landscape of esophageal squamous cell carcinoma and esophageal adenocarcinoma incidence and mortality in 2020 and projections to 2040: new estimates from GLOBOCAN 2020. Gastroenterology. 2022;163(3):649-658.e2. doi:10.1053/j.gastro.2022.05.054 - DOI - PubMed
    1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7-33. doi:10.3322/caac.21708 - DOI - PubMed
    1. Patel MA, Kratz JD, Lubner SJ, Loconte NK, Uboha NV. Esophagogastric cancers: integrating immunotherapy therapy into current practice. J Clin Oncol. 2022;40(24):2751-2762. doi:10.1200/JCO.21.02500 - DOI - PMC - PubMed
    1. Domper Arnal MJ, Ferrández Arenas Á, Lanas Arbeloa Á. Esophageal cancer: risk factors, screening and endoscopic treatment in Western and Eastern countries. World J Gastroenterol. 2015;21(26):7933-7943. doi:10.3748/wjg.v21.i26.7933 - DOI - PMC - PubMed
    1. Alexandre L, Long E, Beales IL. Pathophysiological mechanisms linking obesity and esophageal adenocarcinoma. World J Gastrointest Pathophysiol. 2014;5(4):534-549. doi:10.4291/wjgp.v5.i4.534 - DOI - PMC - PubMed

MeSH terms

Supplementary concepts