Clustering of Esophageal Cancer: Differences by Histology.
Clustering of Esophageal Cancer: Differences by Histology.
复制标题
食管癌的聚集：组织学差异。
DOI：
10.1053/j.gastro.2022.09.003
复制
发表时间：
2023
期刊：
影响因子：
29.4
通讯作者：
Rubenstein,JoelH
中科院分区：
文献类型：
--
作者：
Rubenstein,JoelH
I read with great interest the article published in the August 2022 issue of Gastroenterology by Ma et al,“Factors Associated With Geographic Disparities in Gastrointestinal Cancer Mortality in the United States.” 1 The authors demonstrated geographic variability in the mortality from 4 cancers, and that the known patient and structural factors account for up to 61% of that variability. However, the results regarding esophageal cancer are difficult to interpret because there are 2 histologic subtypes of esophageal cancer—adenocarcinoma and squamous cell carcinoma—each with distinct risk factors. Most importantly, adenocarcinoma is the predominant type in White Americans and squamous cell carcinoma the predominant type in Black Americans. Unfortunately, the platform used, the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER), does not provide information on histology.We previously used the National Program of Cancer Registries to demonstrate that state-level disparities in esophageal adenocarcinoma mortality among non-Hispanic White men is similar to what Ma et al found for esophageal cancer mortality overall. 2 However, there is a very different pattern for esophageal squamous call carcinoma mortality among non-Hispanic Black men, with the highest-risk states in the southeastern US and bordering the Mississippi River (very similar to the patterns that Ma et al observed for pancreatic and colorectal cancer risk). Furthermore, we examined the county-level mortality from esophageal cancer among non-Hispanic White men using the Vital Statistics Cooperative Program Multiple Causes of Death Files (this analysis was not informative for Black men owing to small numbers of cases in individual counties). Even after adjusting for known risk factors, there were areas of high esophageal cancer mortality among non-Hispanic White men stretching from the eastern Great Lakes to New England, as well as western Washington and northern Oregon. Since that publication, Cattelan et al published an analysis of clustering of esophageal cancer incidence by histologic subtype within Canada by postal code. 3 They found that the risk of esophageal adenocarcinoma mirrored what we had observed south of the border, with clusters in southern Vancouver Island (which borders Washington), eastern Lake Ontario (across from northern New York), and Nova Scotia and Prince Edward Island (Gulf of St Lawrence, east of Maine).
