Cancer of the esophagus
is a common cancer in developing areas of the world (Asia, Africa and Latin
America), but is less common in the United States. Historically, most esophageal
cancers were squamous cell tumors. Recently, however, there has been a marked
increase in adenocarcinoma of the esophagus, primarily among white men, in developed
countries of the world, including the United States. In fact, among white men,
rates of adenocarcinoma of the esophagus nearly equal those of squamous cell
tumors.
There is a five-fold range
in the age-adjusted incidence rates for esophageal cancer among the racial/ethnic
groups in the SEER regions. Men are three to five times more likely than women
to be diagnosed with esophageal cancer. Among men, blacks have the highest rate
(15.0 per 100,000) and Filipinos have the lowest (2.9 per 100,000). The incidence
rate for black men is 60% higher than that for Hawaiians and more than 2.7 times
greater than the rate for non-Hispanic white men. The rates for Chinese, Japanese
and non-Hispanic white men are similar to each other (within the range of 5.3
to 5.6 per 100,000 men) and are modestly higher than the rate for white Hispanic
men. Limited data are available for women. Hispanic and non-Hispanic white women
have lower rates than black women. Incidence rates generally increase with age
in all racial/ethnic groups. In black men, however, the incidence rate for the
55-69 year age group is close to the rate for the 70 and over age group. In
black women aged 55-69 years, the incidence rate is slightly higher than for
the 70 years and older age group.
United States mortality
rates for esophageal cancer are nearly as high as incidence rates in the SEER
regions, reflecting the generally poor survival for patients with this cancer.
Among black and Hawaiian populations, the incidence-to-mortality rate ratio
is less than 1.1. It is 1.1 for non-Hispanic whites, Japanese and Filipinos
and 1.3 for Chinese and white Hispanics. Mortality patterns by age are similar
to those seen in the incidence rates.
Heavy alcohol consumption,
cigarette smoking, and, possibly, other types of tobacco use each substantially
increase the risk of esophageal cancer among persons in developed countries.
The use of tobacco and alcohol, in combination, results in even larger elevations
in risk. In developing countries, nutritional deficiencies related to lack of
fresh fruit and vegetables, drinking hot beverages, and a range of chewing and
smoking habits are also important risk factors.
Source: Miller BA,
Kolonel LN, Bernstein L, Young, Jr. JL, Swanson GM, West D, Key CR, Liff JM,
Glover CS, Alexander GA, et al. (eds). Racial/Ethnic Patterns of Cancer in the
United States 1988-1992, National Cancer Institute. NIH Pub. No. 96-4104. Bethesda,
MD, 1996.
Graphs showing incidence and mortality for specific racial and ethnic
groups including information that may not be discussed in the text above,
is available at the NCI's Surveillance, Epidemiology, and End Results
(SEER) Web site at: http://seer.cancer.gov/.
Back to Top |