Substantial increase of oesophageal cancer prevalence in the middle-aged

Data on the prevalence of oesophageal adenocarcinoma and Barrett’s oesophagus (BE) in people between 45 and 64 years of age is concerning. From 2012 to 2019, the prevalence of oesophageal cancer almost doubled in this age group.

“While the prevalence of oesophageal cancer (EC) and Barrett’s oesophagus is thought to have plateaued in recent years, our team wondered whether this apparent trend could be age-dependent,” explained Prof. Bashar J. Qumseya (University of Florida, FL, USA) [1]. He and his team analysed changes in the prevalence of EC and BE from 2012 to 2019, based on the OneFlorida Clinical Data Network with records of over 5 million patients. The findings were reported for 3 age groups: young (18–44), middle-aged (45–64), and elderly patients (>65).

While the prevalence of oesophageal adenocarcinoma was highest in the elderly, it was quite stable over time. In contrast, the prevalence of EC rose from 49/100,000 in 2012 to 94/100,000 in 2019 in the middle-aged. It was paralleled by an also logarithmic increase in the prevalence of BE, a primary precursor of oesophageal adenocarcinoma, from 304/100,00 to 466/100,000 over the same time in those aged between 45–64 years. Assessing this augmented BE prevalence for the middle-aged in subgroups, the highest increase was found in those aged between 51–60 years.

“Whenever we see an increase in any type of cancer, we always have to ask if this could be due to better screening, or more frequent screening, but unfortunately this was not the case here,” commented Prof. Qumseya. His group explored this possible explanation for the rise and found stable rates for the utilisation of gastroscopy in the same population.

“This should be of great concern to physicians and patients, and maybe we should consider screening for BE and EC in middle-aged patients or at younger ages,” Prof. Qumseya said in his concluding remarks. “Our data from the same cohort shows that many people who have 4 or more risk factors for this disease have never had an endoscopy – we can definitively do better!” He suggested that, for example, conducting a gastroscopy at the same time as a screening colonoscopy could be helpful to find more cases of BE and EC, and hopefully prevent this disease from progressing.

1. Qumseya BJ, et al. Alarming increase in prevalence of esophageal cancer and Barrett’s esophagus in middle-aged patients: findings from a statewide database of over five million patients. Lecture 671, Digestive Disease Week 2022, 21–24 May, San Diego, CA, USA.

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Posted on 14 June 202221 May 2024