Comparative epidemiological characteristics of oesophageal adenocarcinoma and other cancers of the oesophagus and gastric cardia.

ABSTRACT

Secular trends and epidemiological characteristics of 1,581 oesophageal cancers, diagnosed in South Australian residents in 1977-2000, were analysed by histological type and diagnostic period, using multivariable Poisson regression and logistic regression. The age-adjusted incidence of squamous cell carcinoma did not vary significantly by diagnostic period, either in males (p = 0.195) or females (p = 0.087). By comparison, variations were observed for adenocarcinomas in males (p<0.001) and females (p = 0.015), with an increase in age-adjusted incidence of 169% for males and 150% for females between 1977-81 and 1997-2000. Most of these increases occurred in the 1990s. Secular differences were not evident for tumours of other or unknown histological type. The ratio of adenocarcinomas to squamous cell carcinomas was higher in patients who were aged 80 years or more, male, residents of high socio-economic areas, and those born in the United Kingdom/Ireland. Conversely, relatively low ratios presented for patients born in Southern and other parts of Europe. These differences by country of origin accord with differences between the national incidence rates for these countries, as indicated by international data. Differences in secular trend and country of birth between adenocarcinomas of the oesophagus and gastric cardia suggest that they are not expressions of the same disease. Preventive implications of these results are discussed.