Adults aged 45 to 64 years experienced an almost doubled rate of esophageal cancer and a 50% increase in the precancerous condition of Barrett’s esophagus between 2012 and 2019, according to a database analysis of roughly five million patients presenting at Digestive Disease Week 2022San Diego, California.
“This strong growth in prevalence should be of concern to physicians, and we should consider screening more middle-aged patients for esophageal cancer if they are at higher risk,” said Bashar J Qumseya, MD, MPH, FASGE, lead author of ‘ the study and professor of medicine and head of endoscopy at the University of Florida, Gainesville.
“When we look at the increasing prevalence of each type of cancer, we have to ask whether this is solely due to better screening or is it a real increase in the disease prevalence. In our study, it came down to the latter.”
The study team assessed the rate of esophagogastroduodenoscopy (EGD) in this time frame and found no increase that could explain the prevalence data. An EGD is a diagnostic endoscopic test to examine the esophagus, stomach and first part of the small intestine (duodenum).
Esophageal cancer and Barrett’s esophagus are most commonly found in older white men, and the study found that the highest incidence remains among those over 65. per 100,000 to 94 per 100,000, while the prevalence of Barrett’s esophagus in this group increased by about 50%, from 304 to 466 per 100,000 patients.
Qumseya said middle-aged patients with multiple risk factors benefit from earlier and / or more frequent screening, compared to the benefit of earlier screening for colorectal cancer.
“From other analyzes we have performed with this dataset, we know that even patients with four or more risk factors for esophageal cancer do not have endoscopy,” he added. “That, from both the patient and provider perspective, we can do better.”
The study was a cross-sectional analysis of electronic health record (EHR) data from the OneFlorida Clinical Data Research Network, which covers more than 40% of Florida’s residents. Researchers analyzed records by three age categories, 18 to 44, 45 to 64 and over 65. Further analysis on the database is ongoing, and the final results should be ready in the next six months.
Qumseya noted several limitations of the study: it covers only adults living in Florida; it was not a randomized controlled trial that followed one group of patients over time; in addition, as with any database, there may be problems with the data itself. The EHRs analyzed were from patients who visited hospitals or doctor’s offices, so the database does not indicate whether they already had an illness at the time of that visit or whether the condition was resolved.
In the definitive analyzes, the research team plans to revisit the database to try to distinguish between the two types of esophageal cancer – esophageal adenocarcinoma, which normally affects the lower esophagus, and squamous cell carcinoma, which affects the upper esophagus affects.
Alarming rise in cases of esophageal cancer in middle-aged adults: US study
Source link Alarming rise in cases of esophageal cancer in middle-aged adults: US study