Trends in the incidence and survival of patients with esophageal cancer: A SEER database analysis
Trends in the incidence and survival of patients with esophageal cancer: A SEER database analysis
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DOI：
10.1111/1759-7714.13311
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发表时间：
2020-05-01
期刊：
影响因子：
2.9
通讯作者：
Fu, Junke
中科院分区：
文献类型：
--
作者：
He, Haiqi;Chen, Nanzheng;Fu, Junke
背景 最近的研究表明，过去十年来美国食管癌的发病率有所下降。然而，发病率和生存率的趋势尚未得到彻底检查。方法从监测、流行病学和最终结果数据库中收集了 1973 年至 2015 年间 46 063 名食管癌患者的数据。采用连接点回归模型分析年龄调整后的发病率和生存率的趋势。结果 1973年至2004年间，食管癌年龄调整后的发病率从每10万人年5.55人增加到7.44人年，随后以每年1.23%的百分比变化下降。在过去 40 年里，男性的强势优势略有增加。重要的是，患有局部鳞状细胞癌的患者比例有所下降。据观察，食管鳞癌的发病率自1986年以来有所下降，而食管腺癌的发病率自1973年以来急剧上升，并超过了鳞状细胞癌的发病率，这主要是由于男性发病率的增加。一致地，食管腺癌的估计 40 年限期患病率高于食管鳞状细胞癌。此外，我们在研究期间观察到生存率有适度但显着的改善。 结论 在过去四十年中，美国食管鳞状细胞癌的发病率显着下降，而腺癌的发病率有所增加，特别是在男性中。总体而言，食管癌患者的长期生存率较差，但在过去几十年中有所改善，尤其是局部疾病。 要点 研究的重大发现 自 2004 年以来，食管癌发病率以每年 1.23% 的百分比变化下降。食管腺癌的发病率自 1973 年以来急剧上升，超过了鳞状细胞癌，主要是由于男性发病率的增加。研究补充说，过去几十年来，美国食管癌组织学亚型的患病率发生了变化。我们发现食管鳞状细胞癌的发病率持续下降，而食管腺癌的发病率持续上升。
Background Recent studies have indicated that the incidence of esophageal cancer has declined in the past decade in the U.S. However, trends in the incidence and survival have not been thoroughly examined.Methods Data from 46 063 patients with esophageal cancer between 1973 and 2015 were collected from the Surveillance, Epidemiology, and End Results database. The trends in the age-adjusted incidence and survival were analyzed using joinpoint regression models.Results The age-adjusted incidence of esophageal cancer increased from 5.55 to 7.44 per 100 000 person-years between 1973 and 2004. Later, it decreased at an annual percentage change of 1.23%. In the last 40 years, the strong male predominance increased slightly. Importantly, the percentage of patients with localized stage of squamous cell cancer decreased. It was observed that the incidence of esophageal squamous cell carcinoma declined since 1986, while the incidence of esophageal adenocarcinoma sharply increased since 1973 and surpassed the rate of squamous cell cancer, mainly due to the increase in the incidence among men. Consistently, the estimated 40-year limited-duration prevalence of esophageal adenocarcinoma was higher than that of esophageal squamous cell carcinoma. Additionally, we observed a modest but significant improvement in survival during the study period.Conclusion The incidence of esophageal squamous cell carcinoma has decreased significantly over the past four decades in the U.S., while the incidence of adenocarcinoma has increased, particularly among men. Overall, the long-term survival of patients with esophageal cancer is poor but it has improved over the past decades, especially for the localized disease.Key points Significant findings of the studyThe incidence of esophageal cancer has decreased at an annual percentage change of 1.23% since 2004. The incidence of esophageal adenocarcinoma has sharply increased since 1973 and surpassed the rate of squamous cell cancer, mainly due to the increase in the incidence among men.What this study addsThere has been a shift in the prevalence of esophageal cancer histological subtypes over the past decades in the U.S. We found that the incidence of esophageal squamous cell carcinoma has continued to decrease, while the esophageal adenocarcinoma rate has continued to increase.