The Evolving Landscape of Esophageal Cancer: A Four-Decade Analysis

Abstract

The incidence of esophageal cancer in the United States seems to have significantly increased since the 1970s. In undertaking this study, we sought to describe changes in the incidence, histologic type, and presenting stage of esophageal cancer over the past four decades. With Institutional Review Board approval, the Surveillance, Epidemiology, and End Results database of the National Cancer Institute was queried. Regression analysis was used to analyze data, and significance was accepted with 95 per cent probability. Forty-two thousand seven hundred thirty-nine patients had squamous cell carcinoma or adenocarcinoma located in their upper, middle, and/ or lower esophagus from 1973 through 2010, reflecting a 7.5-fold annual increase from 1973 through 2010. Squamous cell carcinoma increased annually 2.5-fold ( P < 0.001) and esophageal adenocarcinoma increased annually 57-fold from 1973 through 2010 ( P < 0.001), whereas the overall population in the United States increased only 43 per cent (215,092,900 to 308,745,538) in the same period. From 1973 through 2010, there was a significant increase in the incidence of esophageal cancer in the United States. This increase was much greater than the increase in the population in the United States. The incidence of adenocarcinoma increased much more than that of squamous cell carcinoma of the esophagus from 1973 through 2010.

Characterization of the Psychological Typology in Esophageal Cancer Patients

“…Due to the environment, the life cycle, and the vicissitudes of people, it is a dynamic and evolving process. When facing life’s events, greater flexibility and equilibrium become possible through resilience 1 , 10 - 13 .…”

Epidemiology of Gastrointestinal Diseases

“…Of approximately 450,000 annual cases of esophageal cancer worldwide, 88% are esophageal squamous cell carcinomas (ESCC) and 12% are esophageal adenocarcinomas (EAC) (Arnold et al 2015). In the last several decades, the incidence of ESCC has decreased in the United States, Europe, Australia, and many Western countries, where the incidence of EAC has significantly increased (Rosemurgy et al 2019). In contrast, ESCC is still predominant in two geographic belts, the "Asian esophageal cancer belt" across central Asia from the Caspian Sea to northern China, and a belt on the eastern coast of Africa, from Ethiopia to South Africa, where esophageal carcinoma occurs almost exclusively as ESCC (Arnold et al 2015;Yan et al 2011).…”

Robotic Complex Fundoplication in Patients at High-Risk to Fail

“…Over the last four decades there has been a 57-fold increase in the incidence of esophageal adenocarcinoma. 3 In the United States, it is estimated that 16,910 patients will be diagnosed with esophageal cancer in 2020, and 15,690 will die. 1 Laparoscopic fundoplication, a more efficacious and durable alternative to medical therapy, is currently considered the "gold standard" surgical treatment for GERD.…”