Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Dec 16, 2023; 15(12): 715-724
Published online Dec 16, 2023. doi: 10.4253/wjge.v15.i12.715
Disparities in esophageal cancer incidence and esophageal adenocarcinoma mortality in the United States over the last 25-40 years
Hafiz Muhammad Sharjeel Arshad, Umer Farooq, Ayesha Cheema, Ayesha Arshad, Muaaz Masood, Kenneth J Vega
Hafiz Muhammad Sharjeel Arshad, Ayesha Cheema, Kenneth J Vega, Division of Gastroenterology & Hepatology, Augusta University - Medical College of Georgia, Augusta, GA 30912, United States
Umer Farooq, Department of Internal Medicine, Loyola Medicine/MacNeil Hospital, Berwyn, IL 60402, United States
Ayesha Arshad, Department of Medicine, Fatima Memorial Medical College, Lahore 54000, Punjab, Pakistan
Muaaz Masood, Department of Medicine, Augusta University - Medical College of Georgia, Augusta, GA 30912, United States
Author contributions: Arshad HMS and Vega KJ designed the research study; All authors performed the research; Arshad HMS and Vega KJ analyzed the data and wrote the manuscript; All authors have read, edited and approve the final manuscript version.
Institutional review board statement: Studies using SEER database are considered exempt by the Institutional Review Board of Augusta University-Medical College of Georgia.
Informed consent statement: This study utilized SEER cancer incidence and mortality data from population-based cancer registries covering approximately 47.9 percent of the U.S. population which did not require a specific informed consent.
Conflict-of-interest statement: All the authors have no relevant financial or non-financial interests to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kenneth J Vega, AGAF, FACG, FACP, MD, Professor, Division of Gastroenterology & Hepatology, Augusta University - Medical College of Georgia, 1120 15th Street AD 2226, Augusta, GA 30912, United States. kvega@augusta.edu
Received: September 5, 2023
Peer-review started: September 5, 2023
First decision: September 29, 2023
Revised: October 17, 2023
Accepted: November 13, 2023
Article in press: November 13, 2023
Published online: December 16, 2023
ARTICLE HIGHLIGHTS
Research background

Esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC) frequency have changed and are continuing to change in the United States (US).

Research motivation

To determine EAC/ESCC incidence among the 3 main US racial groups and investigate US EAC survival by ethnicity.

Research objectives

To investigate time trends in EAC/ESCC incidence among the 3 main US racial groups and investigate trends in US EAC survival by ethnicity.

Research methods

Analysis of 25 years (1992-2016) SEER 13 data to compare incidence trends in EAC and ESCC between non-Hispanic whites (nHW), non-Hispanic Blacks (nHB) and Hispanics (Hisp). In addition, SEER 18 data, from 1975-2015, on EAC in the US was analyzed to evaluate racial disparities in incidence and survival among nHW, nHB and Hisp.

Research results

In Hisp, the EAC incidence rate increased while ESCC decreased from 1992 to 2016, resulting in EAC as the predominant esophageal cancer subtype in this group since 2011, joining nHW. Furthermore, although ESCC remains the predominant tumor in nHB, the difference between ESCC and EAC has narrowed dramatically over 25 years. EAC survival probabilities were worse in all minority groups compared to nHw.

Research conclusions

Hisp are the 2nd US ethnic group to have EAC as their predominant EC cancer type. Of note, EAC incidence in nHB is increasing at the highest rate nationally. Despite lower EAC incidence in all minority groups compared to nHW, these populations have decreased survival compared to nHW.

Research perspectives

Understanding EAC in Hisp may provide insight regarding changes in EAC incidence among US minority groups. In addition, evaluation of potential factors contributing to worse short and long-term survival for US minority EAC patients is warranted.