Epidemiology of early esophageal adenocarcinoma

Abstract

Background/Aims: Endoscopic resection has become the preferred treatment approach for select early esophageal adenocarcinoma (EAC); however, the epidemiology of early stage disease has not been well defined. Methods: Surveillance Epidemiology and End Results (SEER) data were analyzed to determine age-adjusted incidence rates among major epithelial carcinomas, including EAC, from 1973 to 2017. The percent change in incidence over time was compared according to tumor subtype. Early T-stage, node-negative EAC without metastasis was examined from 2004 to 2017 when precise T-stage data were available. Results: The percent change in annual incidence from 1973 to 2017 was 767% for EAC. Joinpoint analysis showed that the average annual percent change in EAC from 1973 to 2017 was 5.11% (95% confidence interval 4.66, 5.56). The annual percent change appeared to plateau between 2004 and 2017; however, early EAC decreased from 2010 to 2017, with an annual percent change of -5.78%. Conclusions: There has been a 7-fold increase in the incidence of EAC, which was significantly greater than that of the other major epithelial malignancies examined. More recently, the incidence of early EAC has been decreasing. Approximately one in five patients has node negative, potentially resectable early stage disease. Clin Endosc 2022 Feb 11. [Epub ahead of print]

Prebiotic proanthocyanidins inhibit bile reflux-induced esophageal adenocarcinoma through reshaping the gut microbiome and esophageal metabolome

“…Thus, our goal is to identify a safe efficacious agent, for use alone or as an adjuvant, to inhibit reflux-induced EAC by targeting the major drivers and sequelae associated with GERD and BE. Prognosis following a diagnosis of EAC remains poor as evidenced by <20% 5year survival (27), supporting the urgent need for improved preventive strategies.…”

Molecular Biology and Clinical Management of Esophageal Adenocarcinoma

“…Although EAC cases only account for 14% of EC cases worldwide, it is the predominant subtype in Western countries including Western and Northern Europe, Australia, Canada and the USA [18]. In contrast to ESCC, the annual incidence of EAC has drastically increased by 767% with an average rate of 5.11% per year, from 1973 to 2017 in the USA [19]. In 2012, there were approximately 52,000 EAC cases (41,000 male and 11,000 female) worldwide [4].…”

Cranberry Proanthocyanidins Mitigate Reflux-Induced Transporter Dysregulation in an Esophageal Adenocarcinoma Model

“…The incidence of esophageal adenocarcinoma (EAC) has increased by more than 500% in the United States over the last 30 years, yet the 5-year survival rate remains less than 20% [1,2]. This is despite surgical and therapeutic advancements and the widespread use of esophagogastroduodenoscopy (EGD) and anti-reflux medications targeting Barrett's esophagus (BE), the only recognized precursor lesion to EAC [3,4]. Persistent reflux of gastric and duodenal contents, known as gastroesophageal reflux disease (GERD), is the strongest known risk factor, long associated with BE and EAC progression [3][4][5][6][7][8][9].…”

“…This is despite surgical and therapeutic advancements and the widespread use of esophagogastroduodenoscopy (EGD) and anti-reflux medications targeting Barrett's esophagus (BE), the only recognized precursor lesion to EAC [3,4]. Persistent reflux of gastric and duodenal contents, known as gastroesophageal reflux disease (GERD), is the strongest known risk factor, long associated with BE and EAC progression [3][4][5][6][7][8][9]. Tobacco use is a stronger risk factor for esophageal squamous cell carcinoma (ESCC), but also Pharmaceuticals 2023, 16, 1697 2 of 25 imparts about 2-fold increased risk for EAC [10].…”