Exploring the Recent Trend in Esophageal Adenocarcinoma Incidence and Mortality Using Comparative Simulation Modeling

Abstract

Background The incidence of esophageal adenocarcinoma (EAC) has increased five-fold in the United States since 1975. The aim of our study was to estimate future U.S. EAC incidence and mortality and to shed light on the potential drivers in the disease process that are conduits for the dramatic increase in EAC incidence. Methods A consortium of three research groups calibrated independent mathematical models to clinical and epidemiologic data including EAC incidence from the Surveillance, Epidemiology, and End Results (SEER 9) registry from 1975–2010. We then used a comparative modeling approach to project EAC incidence and mortality to year 2030. Results Importantly, all three models identified birth cohort trends affecting cancer progression as a major driver of the observed increases in EAC incidence and mortality. All models predict that incidence and mortality rates will continue to increase until 2030 but with a plateauing trend for recent male cohorts. The predicted ranges of incidence and mortality rates (cases per 100,000 person years) in 2030 are 8.4–10.1 and 5.4–7.4 respectively for males, and 1.3–1.8 and 0.9–1.2 for females. Estimates of cumulative cause-specific EAC deaths among both sexes for years 2011–2030 range between 142,300 and 186,298, almost double the number of deaths in the past 20 years. Conclusions Through comparative modeling, the projected increases in EAC cases and deaths represent a critical public health concern that warrants attention from cancer control planners to prepare potential interventions. Impact Quantifying this burden of disease will aid health policy makers to plan appropriate cancer control measures.

Surveillance endoscopy is associated with improved outcomes of oesophageal adenocarcinoma detected in patients with Barrett's oesophagus

“…Oesophageal adenocarcinoma (EAC) has been increasing in the USA 1. EAC is a highly fatal cancer with a median overall survival of <1 year following diagnosis.…”

Epidemiology and Risk Factors for Esophageal Cancer

“…Likewise, the annual percentage change over the 10-year period from 1999 to 2008 varied widely, a 3.19 % annual increase for men in the Northeast, in contrast to the 0.80 % annual increase observed in the West [ 7 ]. The increase in EAC incidence is predicted to continue until 2030 with a plateauing trend, reaching 8.4-10.1 cases per 100,000 person-years for males and 1.3-1.8 per 100,000 personyears for females [ 8 ].…”

“…The difference was most obvious in the highest incidence areas of Northern and Western Europe (3.4 in men and 0.6 in women), Northern America (3.5 in men and 0.4 in women), and Oceania (3.4 in men and 0.6 in women). Also striking are the predicted incidence rates in 2030, which are estimated at 8.4-10.1 cases per 100,000 person-years for males and 1.3-1.8 per 100,000 person-years for females [ 8 ].…”

“…The mortality rate from esophageal cancer increased from 4.67 to 5.44 cases per 100,000 during the period from 1993 to 2007 for white males and experienced only a minor increase from 0.76 to 0.77 in white females during the same period [ 12 ]. Esophageal cancer mortality rates are predicted to increase in the United States, with most of the deaths contributed to by EAC [ 8 ]. Cause-specifi c EAC deaths for years 2011 to 2030 are estimated to range between 142,300 and 186,298, almost double the number of deaths in the past 20 years, and EAC mortality rates are estimated to reach 5.4-7.4 cases per 100,000 person-years for males and 0.9-1.2 cases per 100,000 person-years for females by 2030 [ 8 ].…”

“…Esophageal cancer mortality rates are predicted to increase in the United States, with most of the deaths contributed to by EAC [ 8 ]. Cause-specifi c EAC deaths for years 2011 to 2030 are estimated to range between 142,300 and 186,298, almost double the number of deaths in the past 20 years, and EAC mortality rates are estimated to reach 5.4-7.4 cases per 100,000 person-years for males and 0.9-1.2 cases per 100,000 person-years for females by 2030 [ 8 ].…”