Gastrointestinal Adenocarcinoma Incidence and Survival Trends in South Australia, 1990–2017

Abstract

Background & Aims: Globally, there has been a concerning rise in the incidence of young-onset cancers. The aim of this study was to provide trends in the incidence and survival of gastrointestinal adenocarcinomas (oesophagus, stomach, pancreas, and colorectal) in South Australia over a 27-year period. Methods: This is a cross-sectional analysis of a prospective longitudinal database including all cases of gastrointestinal adenocarcinomas prospectively reported to the South Australian (State) Cancer Registry from 1990 to 2017. Results: A total of 28,566 patients diagnosed with oesophageal, stomach, pancreatic, or colorectal adenocarcinoma between 1990 and 2017 were included in the study. While the overall incidence for gastrointestinal adenocarcinomas in individuals >50 years has decreased since 2000 (IRR of 0.97 (95% CI 0.94–1.00; p = 0.06)) compared to 1990–1999, the rate amongst individuals aged 18–50 has significantly increased (IRR 1.41 (95% CI 1.27–1.57; p <0.001)) during the same reference time period. Although noted in both sexes, the rate of increase in incidence was significantly greater in males (11.5 to 19.7/100,000; p <0.001). The overall survival from adenocarcinomas across all subsites improved in the >50-year cohort in the last decade (HR 0.89 (95% CI 0.86–0.93; p <0.001)) compared to 1990–1999. In individuals aged 18–50 years, there has only been a significant improvement in survival for colorectal cancer (HR 0.82 (95% CI 0.68–0.99; p <0.04)), but not the other subsites. A lower overall survival was noted for males in both age cohorts (18–50 years—HR 1.24 (95% CI 1.09–1.13; p <0.01) and >50 years—HR 1.13 (95% CI 1.10–1.16; p <0.001), respectively) compared to females. Conclusions: This study from South Australia demonstrates a significant increase in young-onset gastrointestinal adenocarcinomas over the last 28 years, with a greater increase in the male sex. The only significant improvement in survival in this cohort has been noted in colorectal cancer patients.

Young-Onset Gastrointestinal Adenocarcinoma Incidence and Survival Trends in the Northern Territory, Australia, with Emphasis on Indigenous Peoples

“…Although the incidence of GI adenocarcinomas is on the rise, improved survival has been demonstrated in our young-onset cohort. This finding is in contrast to our observations in young-onset adenocarcinomas in South Australia (where the overall survival across all subsites has remained unchanged) [ 5 ]. This trend has been attributed to the significantly improved survival in colonic adenocarcinoma, especially in the last time period.…”

“…Globally, there have been several reports of increasing incidence of early- or young-onset cancers [ 1 , 2 , 3 , 4 ]. Recently, we confirmed this disturbing trend over the past 28 years in South Australia by interrogating data from the South Australian Cancer Registry [ 5 ]. Early life events have long been suspected to play a role in the causation of young-onset cancers [ 6 , 7 ].…”

Young-Onset Pancreatobiliary Cancers—Whereto from Here?

“…Recently, we interrogated the South-Australian Cancer Registry data over the last 3 decades, and reported that there has been a steady increase in the incidence of pancreatic adenocarcinoma amongst individuals less than 50 years of age [8]. Ansari et al [9], too, reported similar findings from the USA.…”

Krebsrisiko bei Prädiabetes und Typ-2-Diabetes mellitus

“…Dank der Vorsorgekoloskopie haben in Deutschland in den letzten 20 Jahren die altersstandisierten Neuerkrankungen um mehr als 20 % und die Darmkrebstodesfälle bei den über 55-Jährigen um mehr als 35 % abgenommen [42]. Es erkranken nun aber immer mehr junge (< 50 Jahre) Erwachsene [17,32,43 Datenquelle: [33].…”

“…Generell erkranken nun mehr und mehr junge Erwachsene (< 50 Jahre) an Prädiabetes-bzw. T2D-assoziierten Malignomen [17,32], einschließlich des Magenkardiakarzinoms [6,12,14] (▶ Abb. 1).…”