Age-specific incidence, treatment, and survival trends in esophageal cancer: a Dutch population-based cohort study.
Acta Oncol
; 61(5): 545-552, 2022 May.
Article
em En
| MEDLINE
| ID: mdl-35112634
ABSTRACT
BACKGROUND:
Data on the age-specific incidence of esophageal cancer are lacking. Our aim was to investigate the age-stratified incidence, treatment, and survival trends of esophageal cancer in the Netherlands, with a focus on adults <50 years. MATERIAL ANDMETHODS:
Patients diagnosed with esophageal cancer were included from the nationwide Netherlands Cancer Registry (1989-2018). Follow-up data were available until 31 December 2018. Annual percentage changes of incidence were analyzed according to age group (<50, 50-74, and ≥75 years) and histology type adenocarcinoma (EAC) and squamous cell carcinoma (ESCC). Treatment trends and relative survival rates (RSR) were estimated by age and stage grouping.RESULTS:
A total 59,584 patients were included. In adults <50 years, EAC incidence tripled (mean increase per year males 1.5%, females 3%), while the incidence of ESCC decreased (mean decrease per year males -5.3%, females -4.3%). Patients <50 years more often presented with advanced disease stages compared to older patients and were more likely to receive multimodality treatments. Most patients <50 years with potentially curable disease were treated with neoadjuvant chemoradiotherapy followed by surgery compared to patients 50-74 and ≥75 years (74% vs. 55% vs. 15%, respectively; p < .001), and received more frequent systemic therapy once staged with palliative disease (72% vs. 54% vs. 19%, respectively; p < .001). The largest RSR improvement was seen in patients <50 years with early-stage (five years +47%), potentially curable (five years +22%), and palliative disease (one year +11%). Over time, a trend of increasing survival difference was seen between patients <50 and ≥75 years with potentially curable (five-year difference 17% to 27%) and palliative disease (one-year difference 11% to 20%).CONCLUSION:
The incidence of EAC is increasing in adults <50 years in the Netherlands. Differences in the use of multimodality treatments with curative or life-prolonging intent in different age categories may account for increasing survival gaps.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Esofágicas
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Adenocarcinoma
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article