Esophageal Cancer Rates Nearly Double in Adults 45 to 64 Over 7 Years

Rates of esophageal cancer nearly doubled in adults aged 45 to 64 years between 2012 and 2019, according to the results of an analysis of approximately 5 million individuals.

In addition, rates of the precancerous condition, Barrett esophagus rose approximately 50% for the group during the same period.

The analysis is set to be presented at Digestive Disease Week 2022.

“This strong growth in prevalence should be of concern to physicians, and we should consider screening more middle-aged patients for esophageal cancer if they are at higher risk,” Bashar Qumseya, MD, MPH, FASGE, associate professor of medicine and chief of endoscopy at the University of Florida at Gainesville, said in a statement. “Whenever we see increasing prevalence of any type of cancer, we should ask whether this is merely due to better screening or it is a true increase in the disease prevalence. In our study, it was due to the latter.”

Investigators assessed the rate of esophagogastroduodenoscopy (EGD), an endoscopic test that examines the esophagus, first part of the small intestine, and stomach, during this time period and found no increase that explained the prevalence of the data.

Additionally, investigators found that the cancer rate increased to approximately 94 per 100,000 individuals from approximately 49 per 100,000 individuals.

The prevalence of Barrett esophagus in this group also rose approximately 50% to 466 from 304 per 100,000 individuals.

Both Barrett esophagus and esophageal cancer are most commonly found in older white males, and the study results showed that the highest incidence continues to be for those older than aged 65 years, investigators said.

Other risk factors include advanced age, alcohol consumption, male sex, obesity, and smoking.

Individuals who are middle-aged and have multiple risk factors would benefit from earlier and/or more frequent screening, Qumseya said.

He compared it to the benefits of earlier colorectal cancer screening.

“Many patients in the [United States] now have colonoscopies starting at age 45, so conducting an endoscopy at the same time, among those with multiple risk factors, could help capture more patients with Barrett’s esophagus and esophageal cancer,” Qumseya said.

The results of other analyses showed that individuals with 4 or more risk factors for esophageal cancer are not getting endoscopies, he added.

The study was a cross-sectional analysis of electronic health record data from the OneFlorida Clinical Data Research Network, which covers more than 40% of Florida residents. The investigators analyzed records from 3 age groups: aged 18 to 44 years; aged 45 to 64 years;; and older than aged 65 years.

The population was not followed over a group of time, so the results could have been limited as a result, he said.

Further analysis on the database is ongoing, and final results should be ready within 6 months, investigators said.

In the final analyses, the investigators plan to revisit the database to differentiate between the 2 types of esophageal cancer: esophageal adenocarcinoma, which is cancer in the lower esophagus, and squamous cell carcinoma, which is cancer in the upper esophagus.

Reference

Alarming rise found in esophageal cancer and Barrett’s esophagus in middle-aged adults. EurekAlert. News release. May 13, 2022. Accessed May 13, 2022. https://www.eurekalert.org/news-releases/952235