CHANGING TRENDS IN ESOPHAGEAL CANCER - A 15-YEAR EXPERIENCE IN A SINGLE-CENTER

Objective: Esophageal adenocarcinoma is increasing in white men. We so ught to identify trends in esophageal cancer in different patient grou ps in our region. Methods: We reviewed the records of all patients wit h esophageal cancer seen at two hospitals in Columbia, SC between 1981 and 1995. Patients were divided into three cohorts (1981-1985, 1986-1 990, and 1991-1995), Demographic data, histological type, tumor stage, grade, and survival mere recorded. Results: Histology was available in 371 of 386 patients (cohort 1, 113 patients; cohort 2, 144; and cohor t 3, 114). Adenocarcinoma accounted for 24%, 27%, and 49% of esophagea l cancer in white men in cohorts 1, 2, and 3, respectively (p = 0.03). Corresponding figures for African-Americans were 10%, 7%, and 3% (p = 0.22). Women comprised 8%, 14%, and 22% of patients with squamous car cinoma in the three cohorts (p = 0.03), Median survival for esophageal cancer was 6.0, 6.8, and 10.4 mo in cohorts 1, 2, and 3 (p = 0.0002). Conclusion: Adenocarcinoma is increasing in whites. Squamous carcinom a remains the predominant type in this region, seen mainly in African- Americans. Esophageal squamous carcinoma is increasing in women. The m ean age at diagnosis of squamous carcinoma has decreased in whiles. Th ere is a trend toward improved survival in patients with esophageal ca ncer. (C) 1998 by Am. Cell. of Gastroenterology.