Figure 1. Esophageal cancer incidence by country.
Figure 2. Esophageal adenocarcinoma has increased almost 10-fold in incidence over the past four decades among white males in the U.S., although it now appears to be leveling off.

In 2018, it is estimated that more than 550,000 new cases of esophageal cancer (both types) will have occurred worldwide, making it the seventh most commonly occurring cancer and the sixth most common cause of cancer death.1

In lower income regions, squamous cell carcinoma is by far the most common histological type. Particularly high rates occur in parts of China, Central Asia and Eastern Africa (figure 1.) In contrast, the United States and much of Western Europe and Australia has seen a remarkable rise in the incidence of esophageal adenocarcinoma (EAC) which has transformed it from a relative rarity in the 1970s to the most common histological type of esophageal cancer in the U.S. today.2–5

EAC is most common among white males, in whom incidence has increased about 10-fold in the U.S. since the early 1970s (figure 2.)6 Incidence rates in other groups also have risen, although from a much lower baseline rate. Like many solid tumors, EAC incidence rises rapidly with age (figure 3, left graph.) Persons diagnosed with Barrett’s esophagus are substantially more likely (about 20-fold at 60 years of age) to develop EAC than the general population (figure 3, right graph.)7

Figure 3. Incidence of EAC in U.S. In the general population (left graph) EAC is much more common among white males at all ages. Persons with Barrett’s esophagus (right graph) are at substantially higher risk of developing EAC (note the very different scales) than in the general population.7

References:

1.            Cancer today. Available at: http://gco.iarc.fr/today/home. (Accessed: 19th November 2018)

2.            Hur, C. et al. Trends in esophageal adenocarcinoma incidence and mortality. Cancer 119, 1149–58 (2013).

3.            Islami, F., DeSantis, C. E. & Jemal, A. Incidence Trends of Esophageal and Gastric Cancer Subtypes by Race, Ethnicity, and Age in the United States, 1997-2014. Clin. Gastroenterol. Hepatol. (2018). doi:10.1016/j.cgh.2018.05.044

4.            Malhotra, G. K. et al. Global trends in esophageal cancer. J. Surg. Oncol. 115, 564–579 (2017).

5.            Xie, S.-H. & Lagergren, J. Risk factors for oesophageal cancer. Best Pract. Res. Clin. Gastroenterol. (2018). doi:10.1016/j.bpg.2018.11.008

6.            Vaughan, T. L. & Fitzgerald, R. C. Precision prevention of oesophageal adenocarcinoma. Nat. Rev. Gastroenterol. Hepatol. 12, 243–248 (2015).

7.            Anon. IC-RISC. Available at: https://ic-risc.fredhutch.org/ [Accessed February 14, 2019].