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. 2005 Nov;97(11):1471–1478.

Esophageal cancer epidemiology in blacks and whites: racial and gender disparities in incidence, mortality, survival rates and histology.

Claudia R Baquet 1, Patricia Commiskey 1, Kelly Mack 1, Stephen Meltzer 1, Shiraz I Mishra 1
PMCID: PMC2594901  PMID: 16334494

Abstract

BACKGROUND: Esophageal cancer rate disparities are pronounced for blacks and whites. This study presents black-white esophageal cancer incidence, mortality, relative survival rates, histology and trends for two five-year time periods--1991-1995 and 1996-2000--and for the time period 1991-2000. METHODS: The study used data from the National Cancer Institute's population-based Surveillance Epidemiology End Results (SEER) program with submission dates 1991-2000. Age-adjusted incidence, mortality, relative survival rates and histology for esophageal carcinoma were calculated for nine SEER cancer registries for 1991-2000. Rates were analyzed by race and gender for changes over specified time periods. RESULTS: Esophageal cancer age-adjusted incidence of blacks was about twice that of whites (8.63 vs. 4.39/100,000, p < 0.05). Age-adjusted mortality for blacks, although showing a declining trend, was nearly twice that of whites (7.79 vs. 3.96, p < 0.05). Although survival was poor for all groups, it was significantly poorer in blacks than in whites. Squamous cell carcinoma was more commonly diagnosed in blacks and white females, whereas adenocarcinoma was more common among white males (p < 0.001). CONCLUSIONS: Racial disparities in esophageal cancer incidence, mortality, survival and histology exist. Survival rates from this disease have not significantly improved over the decade. These data support the need for advances in prevention, early detection biomarker research and research on new, more effective treatment modalities for this disease.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blot W. J., Devesa S. S., Kneller R. W., Fraumeni J. F., Jr Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA. 1991 Mar 13;265(10):1287–1289. [PubMed] [Google Scholar]
  2. Blot W. J., McLaughlin J. K. The changing epidemiology of esophageal cancer. Semin Oncol. 1999 Oct;26(5 Suppl 15):2–8. [PubMed] [Google Scholar]
  3. Bollschweiler Elfriede, Wolfgarten Eva, Nowroth Thomas, Rosendahl Ursula, Mönig Stefan P., Hölscher Arnulf H. Vitamin intake and risk of subtypes of esophageal cancer in Germany. J Cancer Res Clin Oncol. 2002 Sep 24;128(10):575–580. doi: 10.1007/s00432-002-0380-z. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bosetti Cristina, Gallus Silvano, Trichopoulou Antonia, Talamini Renato, Franceschi Silvia, Negri Eva, La Vecchia Carlo. Influence of the Mediterranean diet on the risk of cancers of the upper aerodigestive tract. Cancer Epidemiol Biomarkers Prev. 2003 Oct;12(10):1091–1094. [PubMed] [Google Scholar]
  5. Brown C. C. The statistical comparison of relative survival rates. Biometrics. 1983 Dec;39(4):941–948. [PubMed] [Google Scholar]
  6. Brown L. M., Blot W. J., Schuman S. H., Smith V. M., Ershow A. G., Marks R. D., Fraumeni J. F., Jr Environmental factors and high risk of esophageal cancer among men in coastal South Carolina. J Natl Cancer Inst. 1988 Dec 21;80(20):1620–1625. doi: 10.1093/jnci/80.20.1620. [DOI] [PubMed] [Google Scholar]
  7. Brown L. M., Hoover R. N., Greenberg R. S., Schoenberg J. B., Schwartz A. G., Swanson G. M., Liff J. M., Silverman D. T., Hayes R. B., Pottern L. M. Are racial differences in squamous cell esophageal cancer explained by alcohol and tobacco use? J Natl Cancer Inst. 1994 Sep 7;86(17):1340–1345. doi: 10.1093/jnci/86.17.1340. [DOI] [PubMed] [Google Scholar]
  8. Brown L. M., Silverman D. T., Pottern L. M., Schoenberg J. B., Greenberg R. S., Swanson G. M., Liff J. M., Schwartz A. G., Hayes R. B., Blot W. J. Adenocarcinoma of the esophagus and esophagogastric junction in white men in the United States: alcohol, tobacco, and socioeconomic factors. Cancer Causes Control. 1994 Jul;5(4):333–340. doi: 10.1007/BF01804984. [DOI] [PubMed] [Google Scholar]
  9. Calle Eugenia E., Rodriguez Carmen, Walker-Thurmond Kimberly, Thun Michael J. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003 Apr 24;348(17):1625–1638. doi: 10.1056/NEJMoa021423. [DOI] [PubMed] [Google Scholar]
  10. Cossentino Mark J., Wong Roy K. H. Barrett's esophagus and risk of esophageal adenocarcinoma. Semin Gastrointest Dis. 2003 Jul;14(3):128–135. [PubMed] [Google Scholar]
  11. De Stefani E., Deneo-Pellegrini H., Ronco A. L., Boffetta P., Brennan P., Muñoz N., Castellsagué X., Correa P., Mendilaharsu M. Food groups and risk of squamous cell carcinoma of the oesophagus: a case-control study in Uruguay. Br J Cancer. 2003 Oct 6;89(7):1209–1214. doi: 10.1038/sj.bjc.6601239. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. DeVault K. R. Epidemiology and significance of Barrett's esophagus. Dig Dis. 2000;18(4):195–202. doi: 10.1159/000051399. [DOI] [PubMed] [Google Scholar]
  13. Devesa S. S., Blot W. J., Fraumeni J. F., Jr Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer. 1998 Nov 15;83(10):2049–2053. [PubMed] [Google Scholar]
  14. Dietzsch Erin, Laubscher Ria, Parker M. Iqbal. Esophageal cancer risk in relation to GGC and CAG trinucleotide repeat lengths in the androgen receptor gene. Int J Cancer. 2003 Oct 20;107(1):38–45. doi: 10.1002/ijc.11314. [DOI] [PubMed] [Google Scholar]
  15. Engel Lawrence S., Chow Wong-Ho, Vaughan Thomas L., Gammon Marilie D., Risch Harvey A., Stanford Janet L., Schoenberg Janet B., Mayne Susan T., Dubrow Robert, Rotterdam Heidrun. Population attributable risks of esophageal and gastric cancers. J Natl Cancer Inst. 2003 Sep 17;95(18):1404–1413. doi: 10.1093/jnci/djg047. [DOI] [PubMed] [Google Scholar]
  16. Enzinger Peter C., Mayer Robert J. Esophageal cancer. N Engl J Med. 2003 Dec 4;349(23):2241–2252. doi: 10.1056/NEJMra035010. [DOI] [PubMed] [Google Scholar]
  17. Glynn S. A., Albanes D. Folate and cancer: a review of the literature. Nutr Cancer. 1994;22(2):101–119. doi: 10.1080/01635589409514336. [DOI] [PubMed] [Google Scholar]
  18. Henschke U. K., Leffall L. D., Jr, Mason C. H., Reinhold A. W., Schneider R. L., White J. E. Alarming increase of the cancer mortality in the U.S. black population (1950-1967). Cancer. 1973 Apr;31(4):763–768. doi: 10.1002/1097-0142(197304)31:4<763::aid-cncr2820310401>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]
  19. Howe H. L., Wingo P. A., Thun M. J., Ries L. A., Rosenberg H. M., Feigal E. G., Edwards B. K. Annual report to the nation on the status of cancer (1973 through 1998), featuring cancers with recent increasing trends. J Natl Cancer Inst. 2001 Jun 6;93(11):824–842. doi: 10.1093/jnci/93.11.824. [DOI] [PubMed] [Google Scholar]
  20. Lukanich Jeanne M. Section I: epidemiological review. Semin Thorac Cardiovasc Surg. 2003 Apr;15(2):158–166. [PubMed] [Google Scholar]
  21. Mayne Susan T., Navarro Stephanie A. Diet, obesity and reflux in the etiology of adenocarcinomas of the esophagus and gastric cardia in humans. J Nutr. 2002 Nov;132(11 Suppl):3467S–3470S. doi: 10.1093/jn/132.11.3467S. [DOI] [PubMed] [Google Scholar]
  22. Mokdad Ali H., Ford Earl S., Bowman Barbara A., Dietz William H., Vinicor Frank, Bales Virginia S., Marks James S. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003 Jan 1;289(1):76–79. doi: 10.1001/jama.289.1.76. [DOI] [PubMed] [Google Scholar]
  23. Murray Liam, Watson Peter, Johnston Brian, Sloan James, Mainie Inder Mohan Lal, Gavin Anna. Risk of adenocarcinoma in Barrett's oesophagus: population based study. BMJ. 2003 Sep 6;327(7414):534–535. doi: 10.1136/bmj.327.7414.534. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Sewram Vikash, De Stefani Eduardo, Brennan Paul, Boffetta Paolo. Maté consumption and the risk of squamous cell esophageal cancer in uruguay. Cancer Epidemiol Biomarkers Prev. 2003 Jun;12(6):508–513. [PubMed] [Google Scholar]
  25. Shaheen Nicholas, Ransohoff David F. Gastroesophageal reflux, barrett esophagus, and esophageal cancer: scientific review. JAMA. 2002 Apr 17;287(15):1972–1981. doi: 10.1001/jama.287.15.1972. [DOI] [PubMed] [Google Scholar]
  26. Sharp L., Chilvers C. E., Cheng K. K., McKinney P. A., Logan R. F., Cook-Mozaffari P., Ahmed A., Day N. E. Risk factors for squamous cell carcinoma of the oesophagus in women: a case-control study. Br J Cancer. 2001 Nov 30;85(11):1667–1670. doi: 10.1054/bjoc.2001.2147. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Terry Paul D., Lagergren Jesper, Wolk Alicja, Steineck Gunnar, Nyrén Olof. Dietary intake of heterocyclic amines and cancers of the esophagus and gastric cardia. Cancer Epidemiol Biomarkers Prev. 2003 Sep;12(9):940–944. [PubMed] [Google Scholar]
  28. Wang An-Hui, Sun Chang-Sheng, Li Liang-Shou, Huang Jiu-Yi, Chen Qing-Shu, Xu De-Zhong. Genetic susceptibility and environmental factors of esophageal cancer in Xi'an. World J Gastroenterol. 2004 Apr 1;10(7):940–944. doi: 10.3748/wjg.v10.i7.940. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Ward Elizabeth, Jemal Ahmedin, Cokkinides Vilma, Singh Gopal K., Cardinez Cheryll, Ghafoor Asma, Thun Michael. Cancer disparities by race/ethnicity and socioeconomic status. CA Cancer J Clin. 2004 Mar-Apr;54(2):78–93. doi: 10.3322/canjclin.54.2.78. [DOI] [PubMed] [Google Scholar]
  30. Wu Anna H., Crabtree Jean E., Bernstein Leslie, Hawtin Peter, Cockburn Myles, Tseng Chiu-chen, Forman David. Role of Helicobacter pylori CagA+ strains and risk of adenocarcinoma of the stomach and esophagus. Int J Cancer. 2003 Mar 1;103(6):815–821. doi: 10.1002/ijc.10887. [DOI] [PubMed] [Google Scholar]
  31. Wu Anna H., Tseng Chiu-Chen, Bernstein Leslie. Hiatal hernia, reflux symptoms, body size, and risk of esophageal and gastric adenocarcinoma. Cancer. 2003 Sep 1;98(5):940–948. doi: 10.1002/cncr.11568. [DOI] [PubMed] [Google Scholar]
  32. Wu M-T, Wu D-C, Hsu H-K, Kao E-L, Lee J-M. Relationship between site of oesophageal cancer and areca chewing and smoking in Taiwan. Br J Cancer. 2003 Oct 6;89(7):1202–1204. doi: 10.1038/sj.bjc.6601251. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Ye Weimin, Held Maria, Lagergren Jesper, Engstrand Lars, Blot William J., McLaughlin Joseph K., Nyrén Olof. Helicobacter pylori infection and gastric atrophy: risk of adenocarcinoma and squamous-cell carcinoma of the esophagus and adenocarcinoma of the gastric cardia. J Natl Cancer Inst. 2004 Mar 3;96(5):388–396. doi: 10.1093/jnci/djh057. [DOI] [PubMed] [Google Scholar]
  34. Younes M., Henson D. E., Ertan A., Miller C. C. Incidence and survival trends of esophageal carcinoma in the United States: racial and gender differences by histological type. Scand J Gastroenterol. 2002 Dec;37(12):1359–1365. doi: 10.1080/003655202762671215. [DOI] [PubMed] [Google Scholar]
  35. el-Serag Hashem B. The epidemic of esophageal adenocarcinoma. Gastroenterol Clin North Am. 2002 Jun;31(2):421-40, viii. doi: 10.1016/s0889-8553(02)00016-x. [DOI] [PubMed] [Google Scholar]

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