Epidemiology of Esophageal Cancer
Epidemiology of Esophageal Cancer
Jingjing Chen
PREV 701 Cancer Epidemiology
October 29, 2012
Epidemiology of Esophageal Cancer
Background
Esophageal cancer is a gastrointestinal malignancy with an insidious onset and a poor prognosis. Although some patients can be cured, the treatment for esophageal cancer is protracted, decreases quality of life, and is lethal in a significant number of cases. The etiology of esophageal carcinoma is thought to be related to exposure of the esophageal mucosa to noxious or toxic stimuli, resulting in a sequence of dysplasia to carcinoma in situ to carcinoma. By far, the most common esophageal cancer worldwide is squamous cell carcinoma, while the second common subgroup—adenocarcinoma accounts for less than 15% of all esophageal cancers1. Other malignant tumors of the esophagus, such as sarcomas, lymphoma, primary malignant melanoma, and small cell carcinoma, are very rare. Although the clinical treatment of those two main histopathologic types of esophageal cancer, squamous cell carcinoma and adenocarcinoma, is often the same, the etiology and epidemiology are quite different. Therefore, increasing the understanding on the epidemiology of each histopathologc types of esophageal cancer could be helpful to the preventive strategies and treatment.
Descriptive epidemiology
Geographic and demographic distribution
Currently, esophageal cancer, which includes squamous cell carcinoma and adenocarcinoma, types) is the eighth most common incidence of cancer in the word: 481,000 new cases (3.8% of the total) were diagnosed in 2008; and it ranks sixth among all cancer mortality cases because of its extremely aggressive nature and poor survival rate.2 It predominantly affects older age groups: the incidence rate increases as the age grows; children and young adult cases are rarely seen. Additionally, males have almost four times higher incidence rate than females do (Figure 1). Those trends are consistent globally, but generally the
Jingjing Chen
PREV 701 Cancer Epidemiology
October 29, 2012
Epidemiology of Esophageal Cancer
Background
Esophageal cancer is a gastrointestinal malignancy with an insidious onset and a poor prognosis. Although some patients can be cured, the treatment for esophageal cancer is protracted, decreases quality of life, and is lethal in a significant number of cases. The etiology of esophageal carcinoma is thought to be related to exposure of the esophageal mucosa to noxious or toxic stimuli, resulting in a sequence of dysplasia to carcinoma in situ to carcinoma. By far, the most common esophageal cancer worldwide is squamous cell carcinoma, while the second common subgroup—adenocarcinoma accounts for less than 15% of all esophageal cancers1. Other malignant tumors of the esophagus, such as sarcomas, lymphoma, primary malignant melanoma, and small cell carcinoma, are very rare. Although the clinical treatment of those two main histopathologic types of esophageal cancer, squamous cell carcinoma and adenocarcinoma, is often the same, the etiology and epidemiology are quite different. Therefore, increasing the understanding on the epidemiology of each histopathologc types of esophageal cancer could be helpful to the preventive strategies and treatment.
Descriptive epidemiology
Geographic and demographic distribution
Currently, esophageal cancer, which includes squamous cell carcinoma and adenocarcinoma, types) is the eighth most common incidence of cancer in the word: 481,000 new cases (3.8% of the total) were diagnosed in 2008; and it ranks sixth among all cancer mortality cases because of its extremely aggressive nature and poor survival rate.2 It predominantly affects older age groups: the incidence rate increases as the age grows; children and young adult cases are rarely seen. Additionally, males have almost four times higher incidence rate than females do (Figure 1). Those trends are consistent globally, but generally the
References: 1. Esophageal Cancer. Armenian medical network. http://www.health.am/cr/esophageal-cancer/#1. Accessed October 27, 2012. 2. Oesophageal Cancer Incidence, Mortality and Prevalence Worldwide in 2008. International Agency for Research on Cancer, World Health Organization website. http://globocan.iarc.fr/factsheet.asp. Accessed October 27, 2012. 3. Eslick GD. Epidemiology of Esophageal Cancer. Gastroenterol Clin N Am 38 (2009) 17–25. doi:10.1016/j.gtc.2009.01.008. 4. Wheeler JB, Reed CE. Epidemiology of Esophageal Cancer. Surg Clin N Am. 2012; 92(5):1077-87. doi: 10.1016/j.suc.2012.07.008. 5. Blot WJ, Devesa S, Kneller R, Fraumeni JJ. Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA. 1991; 265:1287-9 6 7. Parkin M, Pisani P, Ferlay J. Estimates of the worldwide incidence of 25 major cancers in 1990. Int J Cancer. 1999; I80:827-41. 8. Pohl H, Sirovich B, Welch HG. Esophageal adenocarcinoma incidence: are we reaching the peak? Cancer Epidemiol Biomarkers Prev. 2010; 19:1468-70. doi: 10.1158/1055-9965.EPI-10-0012 9 10. Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J. Cancer Incidence in Five Continents. International Agency for Research on Cancer. Vol. VII. 1997. 11. Blot WJ, McLaughlin JK. The changing epidemiology of esophageal cancer. Semin Oncol. 1999;26:17:2-9. 12. Islami F, Boffetta P, Ren JS, et al. High-temperature beverages and foods and esophageal cancer risk—a systematic review. Int J Cancer. 2009; 125:491-524. 13. Lukanich JM. Section I: epidemiologic review. Semin Thorac Cardiovasc Surg. 2003;15:158-66. 14. Lee CH, Lee JM, WuDC, et al. Independent and combined effects of alcohol intake, tobacco smoking and betel quid chewing on the risk of esophageal cncer in Taiwan. Int J Cancer. 2005; 113:475-82. 15. Chang-Claude J, Bencher H, Blettner M, et al. Familial aggregation of esophageal cancer in a high incidence area in China. Int J Epidemiol. 1997;26:1159-65. 18. Sandler RS, Nyre´n O, Ekbom A, et al. The risk of esophageal cancer in patients with achalasia: a population-based study. J Am Med Assoc. 1995;274:1359–62. 19. Ribeiro U, Rosner MC, Safatle-Ribeiro AV, et al. Risk factors for squamous cell carcinoma of the oesophagus. Br J Surg. 1996;83:1174–85. 20. Cooper JS, Pajak TF, Rubin P, et al. Second malignancies in patients who have head and neck cancer: incidence, effect on survival and implications based on the RTOG experience. Int J Radiat Oncol Biol Phys. 1989;17:449–56. 22. Muto M, Hironaka S, Nakane M, et al. Association of multiple Lugol-voiding lesions with synchronous and metachronous esophageal squamous cell carcinoma in patients with head and neck cancer. Gastrointest Endosc. 2002;56:517–21. Figure 1. Estimated age-standardized rates (World) per 100,000. (Source: GLOBOCAN 2008) Figure 2 Figure 2. Age-specific rate per 100,000. (Source: GLOBOCAN 2008) Figure 3 Figure 3. Incidence rates of esophageal cancer for both sexes, all ages. (Source: GlLOBOCAN, 2008) Figure 4 Figure 4. Age-standardized (to the world population) incidence rates and mortality of esophageal cancer for both sexes. (Source: GLOBOCAN 2008) Figure 5 Figure 5. Estimated age-standardized incidence rate per 100,000 for both sexes, all ages. (Source: GLOBOCAN 2008) Figure 6