The aim of this study was to assess the incidence and trends of oesophageal adenocarcinomas (OACs) and squamous cell carcinomas (OSCCs) in England from 1971 to 2037.
on 220,026 oesophageal cancers diagnosed in England between 1971 and
2013 were extracted. Multiple imputation was used to predict morphology
data were missing. Incidence rates were modelled and extrapolated to
2037 using age-period-cohort models.
The OAC age-standardised incidence rate (ASRs) increase was greatest from 1972 to 1992 (from 4.8 to 12.3 for men and 1.1 to 3 per 100,000 for women) and slowed from 1992 to 2012 (with an increase to 17 for men and 3.8 per 100,000 for women). OSCCs rates decreased from 7.5 to 4.9 from 1972 to 2012 for men. For women, ASRs increased from 5.5 to 5.9 between 1972 and 1992 and then decreased to 4.7 per 100,000 until 2012. Rates until 2032 are predicted to stay stable for OACs and further decrease for OSCCs.
Imputing missing morphology allowed accurate and up-to-date estimates of trends and projections. We observed a slowing down of the increase in OAC ASRs and an overall decrease in OSCC ASRs.
Investigators from Thomas Jefferson University,in Philadelphia estimate more than a five-fold increased risk of developing esophageal adenocarcinoma in persons with Barrett’s esophagus who have a first-degree relative with Barrett’s (compared with those without a family history.)
Esophageal adenocarcinoma in a first-degree relative increases risk for esophageal adenocarcinoma in patients with Barrett’s esophagus
Christina J Tofani, Kunjal Gandhi, Joseph Spataro, …
significance of a family history of esophageal adenocarcinoma in the
progression to esophageal adenocarcinoma in patients with Barrett’s
esophagus has not been thoroughly evaluated. The purpose of this study
is to evaluate the presence of esophageal adenocarcinoma in a
first-degree relative in patients with Barrett’s esophagus.
retrospective cohort study was conducted of patients with Barrett’s
esophagus at a tertiary care center undergoing radiofrequency ablation.
Family history, demographics, and pathology and endoscopy reports were
assessed in all patients.
hundred and one patients with Barrett’s esophagus were assessed.
Nineteen patients who had a diagnosis of esophageal adenocarcinoma on
index endoscopy were excluded. Nineteen (6.7%) patients had a
first-degree relative with esophageal adenocarcinoma. Four (21.1%) of
these patients progressed to esophageal adenocarcinoma. Of patients
without first-degree relative with esophageal adenocarcinoma 22/263
(8.7%) progressed to esophageal adenocarcinoma. In a logistic regression
model adjusted for sex and the number of radiofrequency ablation
treatments, we found that family history of esophageal adenocarcinoma
was a significant independent predictor of progression to esophageal
adenocarcinoma (odds ratio = 5.55, 95% confidence interval: 1.47–20.0).
study indicates that Barrett’s esophagus patients with a first-degree
family member with esophageal adenocarcinoma are at 5.5-fold higher risk
for disease progression to esophageal adenocarcinoma. Family history of
esophageal adenocarcinoma in Barrett’s esophagus patients should be
considered in patient surveillance and radiofrequency ablation
treatment, beyond recommended guidelines.