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Epidemiology of early esophageal adenocarcinoma

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Background/Aims: Endoscopic resection has become the preferred treatment approach for select early esophageal adenocarcinoma(EAC); however, the epidemiology of early stage disease has not been well defined. Methods: Surveillance Epidemiology and End Results (SEER) data were analyzed to determine age-adjusted incidence rates amongmajor epithelial carcinomas, including EAC, from 1973 to 2017. The percent change in incidence over time was compared according totumor subtype. Early T-stage, node-negative EAC without metastasis was examined from 2004 to 2017 when precise T-stage data wereavailable. Results: The percent change in annual incidence from 1973 to 2017 was 767% for EAC. Joinpoint analysis showed that the average annualpercent change in EAC from 1973 to 2017 was 5.11% (95% confidence interval, 4.66%−5.56%). The annual percent change appearedto plateau between 2004 and 2017; however, early EAC decreased from 2010 to 2017, with an annual percent change of −5.78%. Conclusions: There has been a 7-fold increase in the incidence of EAC, which was significantly greater than that of the other major epithelialmalignancies examined. More recently, the incidence of early EAC has been decreasing. Approximately one in five patients hasnode negative, potentially resectable early stage disease.

Abstract

Background/Aims: Endoscopic resection has become the preferred treatment approach for select early esophageal adenocarcinoma(EAC); however, the epidemiology of early stage disease has not been well defined. Methods: Surveillance Epidemiology and End Results (SEER) data were analyzed to determine age-adjusted incidence rates amongmajor epithelial carcinomas, including EAC, from 1973 to 2017. The percent change in incidence over time was compared according totumor subtype. Early T-stage, node-negative EAC without metastasis was examined from 2004 to 2017 when precise T-stage data wereavailable. Results: The percent change in annual incidence from 1973 to 2017 was 767% for EAC. Joinpoint analysis showed that the average annualpercent change in EAC from 1973 to 2017 was 5.11% (95% confidence interval, 4.66%−5.56%). The annual percent change appearedto plateau between 2004 and 2017; however, early EAC decreased from 2010 to 2017, with an annual percent change of −5.78%. Conclusions: There has been a 7-fold increase in the incidence of EAC, which was significantly greater than that of the other major epithelialmalignancies examined. More recently, the incidence of early EAC has been decreasing. Approximately one in five patients hasnode negative, potentially resectable early stage disease.

참고문헌 (32)

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