Demographic variations in the rising incidence of esophageal adenocarcinoma in white males.

BACKGROUND: The rise in adenocarcinoma (AC) of the esophagus has been reported in several papers. However, the results are only comparable to a limited extent, because they are based on differing periods and different computational methods. The purpose of the current investigation was to collect the available data and to analyze them in a unified manner.

METHODS: The authors requested data on the incidence of AC of the esophagus for each year since 1960 from 43 tumor registries in North America, Europe, and Australia. The data from 22 centers were used. The trend was calculated by fitting the data to an exponential growth model.

RESULTS: The incidence of AC of the esophagus in white males is rising in most countries. The highest values of the estimated incidence rate in the year 2000 were found in Great Britain (5.0- 8.7 cases per 100,000 population) and in Australia (4.8 cases per 100,000 population) followed by The Netherlands (4.4 cases per 100,000 population), the United States (3.7 cases per 100,000 population), and Denmark (2.8 cases per 100,000 population). Low rates (< 1.0 cases per 100,000 population) were found in Eastern Europe. The largest changes in incidence were reported in the Southern European countries, with an estimate of the average increase over six registries of 30% per year; in Australia, with an average increase of 23.5% per year; and in the United States, with an average increase of 20.6% per year. The rates of increase ranged from 8.7% to 17.5% on average in Northern Europe, Central Europe, and the United Kingdom. In Eastern Europe, at most, there was a minor rise in incidence.

CONCLUSIONS: In the Western industrialized nations, the analyzed data show that the incidence of AC of the esophagus has been rising rapidly in the last 20 years. The only exceptions to date are the countries of Eastern Europe.