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Tale of Two Cancers

Continued Changes in the Incidence of Esophageal and Gastric Adenocarcinoma

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Crane, Sarah J., M.D.; Locke, G. Richard, M.D.; Harmsen, William S., M.S.; Zinsmeister, Alan R., Ph.D.; Geno, Debra; Romero, Yvonne, M.D.; Talley, Nicholas J., M.D.

American Journal of Gastroenterology: September 2005 - Volume 100 - Issue - p S27–S28
Supplement Abstracts Submitted for the 70th Annual Scientific Meeting of the American College of Gastroenterology: ESOPHAGUS
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Gastroenterology, Mayo Clinic, Rochester, MN.

Purpose: The incidence rates of esophageal and gastric adenocarcinoma (ACa) have been changing over the past 30 years. Time trends in the incidence of ACa of the esophagogastric junction (EGJ) are not as well known as this area is difficult for large databases to define.

Aim: To estimate changes by decade in site specific incidence of esophageal and gastric ACa from 1971–2000.

Methods: Using the unique data resources of the Rochester Epidemiology Project, all cases of gastric and esophageal ACa in Olmsted County, Minnesota between 1971 and 2000 were identified. The complete inpatient and outpatient records of each case were reviewed and the specific site (distal stomach, proximal stomach, EGJ and esophagus) was identified using consistent criteria. Incidence rates were estimated directly and age and sex adjusted to US white 2000 population figures. Age, gender and calendar year effects were evaluated using Poisson regression.

Results: A total of N = 183 cases were identified. The site and decade specific incidence rates are given in Table I. The incidence of distal stomach ACa declined and esophageal ACa increased. Furthermore the incidence of proximal stomach ACa was stable while EGJ increased significantly. In the most recent decade, the incidence of esophageal ACA was numerically higher than stomach ACa.

Table 1

Table 1

Conclusions: In this population, esophageal ACa is now as common as gastric ACa. The complete medical records available for individual review in this study lead to very accurate site-specific identification which allows one to note that proximal gastric ACa incidence remains unchanged while the incidence of EGJ ACa is increasing.

© The American College of Gastroenterology 2005. All Rights Reserved.