Population Based Time Trends in the Epidemiology and Mortality of Gastroesophageal Junction and Esophageal Adenocarcinoma.
Population Based Time Trends in the Epidemiology and Mortality of Gastroesophageal Junction and Esophageal Adenocarcinoma.
复制标题
基于人群的胃食管交界处和食管腺癌的流行病学和死亡率的时间趋势。
DOI：
10.1007/s10620-023-08126-6
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发表时间：
2024
影响因子：
3.1
通讯作者：
Iyer,PrasadG
中科院分区：
文献类型：
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作者：
Agarwal,Siddharth;Bell,MatthewG;Dhaliwal,Lovekirat;Codipilly,DChamil;Dierkhising,RossA;Lansing,Ramona;Gibbons,ErinE;Leggett,CadmanL;Kisiel,JohnB;Iyer,PrasadG
背景关于胃-食管交界腺癌(GEJAC)的流行病学资料有限，尤其是与食管腺癌(EAC)的比较。随着分子非内窥镜Barrett‘s食道(BE)检测试验的出现，早期发现EAC和GEJAC成为可能，其流行病学也变得重要。目的我们试图评估EAC和GEJAC患者在人群队列中的流行病学和生存期的时间趋势。提取临床资料和生存状况。采用泊松回归计算发病率比(IRR)。生存分析和Cox比例模型用于评估生存预测因素。结果纳入443例患者(287例EAC，156例GEJAC)。1976-2019年EAC和GEJAC的发病率分别为每10万人1.40(CI 1.1-1.74)和0.83(CI 0.61-1.11)。与1995年至1999年相比，2000年至2004年EAC(IRR = 2.45，p= 0.011)和GeJAC(IRR = 3.17，p= 0.08)的发病率有所上升，随后趋于平稳。大多数患者合并BE并出现在晚期，导致较高的5年死亡率(EAC组66%，GEJAC组59%)。年龄和诊断阶段是死亡率的预测因素。结论在过去的十年中，EAC/GEJAC发病率的上升似乎有所平缓。然而，这两种癌症都处于晚期，存活率持续较低，这突显了早期发现的必要性。
BackgroundLimited data are available on the epidemiology of gastroesophageal junction adenocarcinoma (GEJAC), particularly in comparison to esophageal adenocarcinoma (EAC). With the advent of molecular non-endoscopic Barrett’s esophagus (BE) detection tests which sample the esophagus and gastroesophageal junction, early detection of EAC and GEJAC has become a possibility and their epidemiology has gained importance.AimsWe sought to evaluate time trends in the epidemiology and survival of patients with EAC and GEJAC in a population-based cohort.MethodsEAC and GEJAC patients from 1976 to 2019 were identified using ICD 9 and 10 diagnostic codes from the Rochester Epidemiology Project (REP). Clinical data and survival status were abstracted. Poisson regression was used to calculate incidence rate ratios (IRR). Survival analysis and Cox proportional models were used to assess predictors of survival.ResultsWe included 443 patients (287 EAC,156 GEJAC). The incidence of EAC and GEJAC during 1976–2019 was 1.40 (CI 1.1–1.74) and 0.83 (CI 0.61–1.11) per 100,000 people, respectively. There was an increase in the incidence of EAC (IRR = 2.45,p= 0.011) and GEJAC (IRR = 3.17,p= 0.08) from 2000 to 2004 compared to 1995–1999, plateauing in later time periods. Most patients had associated BE and presented at advanced stages, leading to high 5-year mortality rates (66% in EAC and 59% in GEJAC). Age and stage at diagnosis were predictors of mortality.ConclusionThe rising incidence of EAC/GEJAC appears to have plateaued somewhat in the last decade. However, both cancers present at advanced stages with persistently poor survival, underscoring the need for early detection.