Arshad HMS, Farooq U, Cheema A, Arshad A, Masood M, Vega KJ. Disparities in esophageal cancer incidence and esophageal adenocarcinoma mortality in the United States over the last 25-40 years. World J Gastrointest Endosc 2023; 15(12): 715-724 [PMID: 38187915 DOI: 10.4253/wjge.v15.i12.715]
Corresponding Author of This Article
Kenneth J Vega, AGAF, FACG, FACP, MD, Professor, Division of Gastroenterology & Hepatology, Augusta University - Medical College of Georgia, 1120 15th Street AD 2226, Augusta, GA 30912, United States. kvega@augusta.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hafiz Muhammad Sharjeel Arshad, Ayesha Cheema, Kenneth J Vega, Division of Gastroenterology & Hepatology, Augusta University - Medical College of Georgia, Augusta, GA 30912, United States
Umer Farooq, Department of Internal Medicine, Loyola Medicine/MacNeil Hospital, Berwyn, IL 60402, United States
Ayesha Arshad, Department of Medicine, Fatima Memorial Medical College, Lahore 54000, Punjab, Pakistan
Muaaz Masood, Department of Medicine, Augusta University - Medical College of Georgia, Augusta, GA 30912, United States
Author contributions: Arshad HMS and Vega KJ designed the research study; All authors performed the research; Arshad HMS and Vega KJ analyzed the data and wrote the manuscript; All authors have read, edited and approve the final manuscript version.
Institutional review board statement: Studies using SEER database are considered exempt by the Institutional Review Board of Augusta University-Medical College of Georgia.
Informed consent statement: This study utilized SEER cancer incidence and mortality data from population-based cancer registries covering approximately 47.9 percent of the U.S. population which did not require a specific informed consent.
Conflict-of-interest statement: All the authors have no relevant financial or non-financial interests to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kenneth J Vega, AGAF, FACG, FACP, MD, Professor, Division of Gastroenterology & Hepatology, Augusta University - Medical College of Georgia, 1120 15th Street AD 2226, Augusta, GA 30912, United States. kvega@augusta.edu
Received: September 5, 2023 Peer-review started: September 5, 2023 First decision: September 29, 2023 Revised: October 17, 2023 Accepted: November 13, 2023 Article in press: November 13, 2023 Published online: December 16, 2023 Processing time: 100 Days and 10.5 Hours
Abstract
BACKGROUND
Esophageal carcinoma presents as 2 types, esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC) with the frequency of both changing in the United States (US).
AIM
To investigate EAC/ESCC incidence time trends among the 3 main US racial groups and investigate trends in US EAC survival by ethnicity.
METHODS
Twenty-five years (1992-2016) of data from SEER 13 program was analyzed to compare incidence trends in EAC and ESCC between non-Hispanic whites (nHW), non-Hispanic Blacks (nHB) and Hispanics (Hisp) using SEERStat®. In addition, SEER 18 data, from 1975-2015, on EAC in the US was analyzed to evaluate racial disparities in incidence and survival using SEERStat® and Ederer II method.
RESULTS
In the 3 major US ethnic groups, age-adjusted incidence of ESCC has declined while EAC has continued to rise from 1992-2016. Of note, in Hisp, the EAC incidence rate increased while ESCC decreased from 1992 to 2016, resulting in EAC as the predominant esophageal cancer subtype in this group since 2011, joining nHW. Furthermore, although ESCC remains the predominant tumor in nHB, the difference between ESCC and EAC has narrowed dramatically over 25 years. EAC survival probabilities were worse in all minority groups compared to nHw.
CONCLUSION
Hisp have joined nHW as US ethnic groups more likely to have EAC than ESCC. Of note, EAC incidence in nHB is increasing at the highest rate nationally. Despite lower EAC incidence in all minority groups compared to nHW, these populations have decreased survival compared to nHW.
Core Tip: There is a higher incidence of esophageal adenocarcinoma (EAC) in non-Hispanic whites (nHw). Esophageal squamous cell carcinoma (ESCC) is more common than EAC in non-Hispanic Blacks. Previous research reported higher incidence of ESCC compared to EAC in Hispanics (Hisp) as well. This study reveals that Hisp have joined nHw as US ethnic groups with EAC as the predominant esophageal cancer. Despite lower EAC incidence in all minority groups compared to nHw, these populations have lower survival compared to nHw.
