Epidemiology

Oesophageal cancer is the eighth most common cancer and the sixth most common cause of cancer-related death in the world. In 2012

• 456,000 new cases were reported which was 3% of all cancers
• 400,000 deaths were reported

Epidemiology of the two main subtypes of oesophageal cancer varies according to the region

• a very high incidence of oesophageal squamous cell carcinoma (SCC) is reported in
  • “Asian esophageal cancer belt”, which encompasses Turkey, northeastern Iran, Kazakhstan, and northern and central China - with more than 100 cases per 100 000 population annually
  • southern and eastern Africa
• prevalence of oesophageal adenocarcinoma is increasing in some Asian countries e.g. - Singapore (1,2)

Incidence of oesophageal cancer is increasing throughout the world.

• incidence of SSC remains stable or declined in the Western countries whilst the incidence of adenocarcinoma has risen more rapidly
  • specially seen in white men
    • in the USA, from 1975 to 2004, age-adjusted incidence of oesophageal carcinoma in white men increased from 5·76 to 8·34 per 100 000 person-years, largely due to 463% increase in oesophageal adenocarcinoma.
• the UK has the highest reported incidence worldwide (2,3)
• it is rare in young people and the incidence increases with age, peaking in the seventh and eighth decade of life (4)

In the UK:

• there were around 8,900 new cases of oesophageal cancer in 2014, that’s 24 cases diagnosed every day
• is the 14th most common cancer (2014)
• 7790 deaths were reported in 2014
• more common in males than females
  • 1 in 55 men and 1 in 115 women will be diagnosed with oesophageal cancer during their lifetime.
• is more common in White people than Asian or Black people
• age-specific incidence rates rise sharply from around age 45-49 years, with the highest rates in the 90+ age group (5)
  • incidence rates are higher for males than females from age 30-34, with no significant differences at younger ages
  • gap is widest at the ages of 40-44, when the male:female ratio of age-specific incidence rates (to account for the different proportions of males to females in each age group) is around 37:10
• most oesophageal cancers occur in the lower third of the oesophagus.
• is more common in people living in the most deprived areas (5)

Reference:

• (1) Thrift AP. The epidemic of oesophageal carcinoma: Where are we now? Cancer Epidemiol. 2016;41:88-95.
• (2) Lagergren J, Lagergren P. Oesophageal cancer. BMJ. 2010;341:c6280.
• (3) Pennathur A et al. Oesophageal carcinoma. Lancet. 2013;381(9864):400-12.
• (4) Lordick F et al. Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;27(suppl 5):v50-v57.
• (5) Cancer Research UK. Oesophageal cancer survival statistics. (Accessed 05/10/2017)