TY - JOUR
T1 - Age-specific incidence, treatment, and survival trends in esophageal cancer
T2 - a Dutch population-based cohort study
AU - Al-Kaabi, Ali
AU - Baranov, Nikolaj S.
AU - van der Post, Rachel S.
AU - Schoon, Erik J.
AU - Rosman, Camiel
AU - van Laarhoven, Hanneke W. M.
AU - Verheij, Marcel
AU - Verhoeven, Rob H. A.
AU - Siersema, Peter D.
N1 - Funding Information: Rob HA Verhoeven has received research grants from Roche and Bristol-Myers Squibb. Hanneke van Laarhoven has served as a consultant for BMS, Celgene, Lilly, Nordic, Philips, and Servier and has received unrestricted research funding from Bayer, BMS, Celgene, Lilly, Merck Serono, MSD, Nordic, Philips, Roche, and Servier. Peter D. Siersema has received research grants from Boston Scientific, Pentax Medical, and The eNose company. Publisher Copyright: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022
Y1 - 2022
N2 - 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 and methods: 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.
AB - 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 and methods: 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.
KW - Esophageal cancer
KW - cancer incidence
KW - survival
KW - time trends
KW - young adult cancers
UR - http://www.scopus.com/inward/record.url?scp=85124324491&partnerID=8YFLogxK
U2 - https://doi.org/10.1080/0284186X.2021.2024878
DO - https://doi.org/10.1080/0284186X.2021.2024878
M3 - Article
C2 - 35112634
SN - 0284-186X
VL - 61
SP - 545
EP - 552
JO - Acta Oncologica
JF - Acta Oncologica
IS - 5
ER -