Global Burden, Risk Factors, and Trends of Esophageal Cancer: An Analysis of Cancer Registries from 48 Countries.
Global Burden, Risk Factors, and Trends of Esophageal Cancer: An Analysis of Cancer Registries from 48 Countries.
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DOI：
10.3390/cancers13010141
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发表时间：
2021-01-05
期刊：
影响因子：
5.2
通讯作者：
Wong MCS
中科院分区：
文献类型：
--
作者：
Huang J;Koulaouzidis A;Marlicz W;Lok V;Chu C;Ngai CH;Zhang L;Chen P;Wang S;Yuan J;Lao XQ;Tse SLA;Xu W;Zheng ZJ;Xie SH;Wong MCS
食管癌是全球第七大常见癌症。预防措施和临床管理因组织亚型而异。然而，根据全球范围内的组织学亚型、相关危险因素和流行病学趋势，缺乏关于其最新模式的信息。本研究基于高质量的人口登记，对超过48个国家/地区的食管癌发病率/死亡率趋势进行了全球分析。我们得出结论，在一些西方国家，腺癌已经超过鳞状细胞癌成为最常见的食管癌类型，并且预计在其他国家还会增加。密切监测和减缓肥胖和代谢综合征的增长速度是重要的，这是腺癌的重要危险因素。随着技术的发展和微创性的提高，基于人群的内镜靶向筛查将被推荐给高危人群。本研究旨在研究食管癌的全球负担、危险因素和基于年龄、性别和组织学亚型的趋势。这些数据是从1980年至2017年期间48个国家的癌症登记处数据库中检索的。发病率和死亡率的时间模式采用平均年变化百分比（AAPC），采用联结点回归。通过线性回归检验与危险因素的关系。食管癌发病率最高的地区为东亚。腺癌（AC）的发病率最高的国家是荷兰、英国和爱尔兰。较高的AC/鳞状细胞癌（SCC）发病率与较高的肥胖和高胆固醇患病率相关。我们观察到一些国家的发病率增加（包括AC和SCC），其中捷克共和国（女性：AAPC 4.66）、西班牙（女性：3.41）、挪威（男性：3.10）、日本（女性：2.18）、泰国（男性：2.17）、荷兰（男性：2.11；女性：1.88）和加拿大（男性：1.51）的发病率增加最为显著。死亡率上升的国家包括泰国（男性：5.24）、奥地利（女性：3.67）、拉脱维亚（男性：2.33）和葡萄牙（男性：1.12）。虽然食管癌的发病率总体呈下降趋势，但在一些AC/SCC发病率较高的国家，食管癌的发病率呈上升趋势。这些国家需要采取更多的预防措施。
Esophageal cancer is the seventh most common cancer globally. Preventive measures and clinical management differ based on histologic subtype. However, information has been lacking on its most recent patterns according to histological subtype, associated risk factors, and epidemiological trends on a global scale. This study is a global analysis of the incidence/mortality trends of esophageal cancer in more than 48 countries/regions based on high quality population-based registries. We conclude that adenocarcinoma has already surpassed squamous cell carcinoma as the most frequent type of esophageal cancer in some western countries and is expected to increase in other countries. It is important to closely monitor and slow down the growing rates of obesity and metabolic syndrome, which are the important risk factors for adenocarcinoma. With the development of more advanced and less invasive technology, population-based targeted screening endoscopy would be recommended for high-risk individuals. This study aimed to examine the global burden, risk factors, and trends of esophageal cancer based on age, sex, and histological subtype. The data were retrieved from cancer registries database from 48 countries in the period 1980–2017. Temporal patterns of incidence and mortality were evaluated by average annual percent change (AAPC) using joinpoint regression. Associations with risk factors were examined by linear regression. The highest incidence of esophageal cancer was observed in Eastern Asia. The highest incidence of adenocarcinoma (AC) was found in the Netherlands, the United Kingdom, and Ireland. A higher AC/squamous cell carcinoma (SCC) incidence ratio was associated with a higher prevalence of obesity and elevated cholesterol. We observed an incidence increase (including AC and SCC) in some countries, with the Czech Republic (female: AAPC 4.66), Spain (female: 3.41), Norway (male: 3.10), Japan (female: 2.18), Thailand (male: 2.17), the Netherlands (male: 2.11; female: 1.88), and Canada (male: 1.51) showing the most significant increase. Countries with increasing mortality included Thailand (male: 5.24), Austria (female: 3.67), Latvia (male: 2.33), and Portugal (male: 1.12). Although the incidence of esophageal cancer showed an overall decreasing trend, an increasing trend was observed in some countries with high AC/SCC incidence ratios. More preventive measures are needed for these countries.
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