Incidence and survival differences in esophageal cancer among ethnic groups in the United States

Abstract

ObjectivesThis study was performed to identify the differences in incidence, clinicopathological features, and survival in esophageal cancer among ethnic groups in the United States and to determine the reasons for the differences.ResultA total of 49,766 patients were included. Black and Asian groups had a higher proportion of squamous cell carcinoma (ESCC) (85.5% and 75.4%, respectively) and mid-esophagus tumor (43.2% and 37.7% respectively) than the non-Hispanic white and Hispanic white groups. The incidences of ESCC in all ethnic groups declined since 1973, especially in black males. At the same time, incidences of esophageal adenocarcinoma (EAC) dramatically increased in white males since 1973. And incidences of ESCC and EAC were the lowest and stable in Asian female. Multivariable models showed that patients who were male, or black, or had larger tumors, or positive lymph nodes had an increased risk of death from esophageal cancer, while patients with ESCC or diagnosed after 2005 or treated with surgery had a lower likelihood of death. For ESCC, the black patients had the lowest DSS, while for EAC there were no significant differences in DSS among the ethnic/racial groups.Materials and MethodFrom the Surveillance, Epidemiology, and End Results Program database, patients diagnosed with esophageal cancer from 1998-2013 were identified. Differences in incidences, clinicopathological features, treatments, and disease-specific survival (DSS) in four broad racial/ethnic groups were compared.ConclusionHistological type distribution between racial groups could be an important consideration in the incidence and the survival trend but other factors could also have an effect.

Sex differences in the prognosis after surgery for esophageal squamous cell carcinoma and adenocarcinoma

“…A few earlier studies have indicated a better prognosis in women with esophageal cancer compared to men . A Swedish register‐based study from our group indicated a lower overall all‐cause mortality in women with esophageal squamous cell carcinoma (HR 0.83, 95% CI 0.78–0.89, n = 4,631), but not in women with esophageal adenocarcinoma .…”

“…A few register‐based studies have suggested a sex disparity in the prognosis of esophageal cancer, but these have not analyzed the histological subtypes separately . In studies that have analyzed the histologic types separately, women diagnosed with esophageal squamous cell carcinoma had a possibly better prognosis than men, while no sex differences were found for esophageal adenocarcinoma . However, these studies were limited by low coverage of the study population, small sample size, or inability to adjust for relevant confounding variables .…”

“…In studies that have analyzed the histologic types separately, women diagnosed with esophageal squamous cell carcinoma had a possibly better prognosis than men, while no sex differences were found for esophageal adenocarcinoma . However, these studies were limited by low coverage of the study population, small sample size, or inability to adjust for relevant confounding variables . Potential sex differences may be explained by differences in the distribution of the main prognostic factors between the sexes, that is, tumor stage, socioeconomic factors (educational level), and comorbidity, but these factors have not been adjusted for in the existing literature.…”

Evaluation of Serum Glycoprotein Biomarker Candidates for Detection of Esophageal Adenocarcinoma and Surveillance of Barrett's Esophagus

“…Of the two main histological subtypes (adenocarcinoma and squamous cell carcinoma), the incidence of esophageal adenocarcinoma (EAC) has been rising continuously in Western countries, and accounts for the majority of cases (3)(4)(5). Despite aggressive treatment, EAC has a 5-year survival of less than 20% (6).…”

Incidence of Esophageal Cancer in Madina Hospital, Somalia

“…6 Unlike esophageal adenocarcinoma, the incidence does not differ significantly between white and African. 7 Anecdotal reports show that the number of esophageal cancers in the hospitals of Somalia is high, and most of these patients are diagnosed in late stages leading to a loss of the chance for a surgical treatment. Our aim was to give highlights on the frequency of esophageal cancer in Madina Hospital in Somalia.…”