title: Esophageal adenocarcinoma incidence: are we reaching the peak?
abstract: BACKGROUND
  A steep increase in the incidence of esophageal adenocarcinoma has been observed between 1973 and 2001, but recent trends have not been reported. Our aim was to examine recent trends in esophageal adenocarcinoma incidence.
  
  
  METHODS
  We used the Surveillance Epidemiology and End Results database of the National Cancer Institute to identify all patients who were diagnosed with esophageal adenocarcinoma between 1973 and 2006. Incidence trends were analyzed for esophageal adenocarcinoma overall and by stage using joinpoint regression.
  
  
  RESULTS
  Overall esophageal adenocarcinoma incidence increased from 3.6 per million in 1973 to 25.6 per million in 2006. Incidence trend analysis, however, suggests that the increase has slowed, from an 8.2% annual increase prior to 1996 to 1.3% increase in subsequent years (P = 0.03). Stage-specific trend analyses suggest that the change in overall esophageal adenocarcinoma incidence largely reflects a plateau in the incidence of early stage disease. Its slope has changed direction, from a 10% annual increase prior to 1999 to a 1.6% decline in subsequent years (P = 0.01).
  
  
  CONCLUSIONS
  The incidence of early stage esophageal adenocarcinoma seems to have plateaued.
  
  
  CONCLUSIONS
  Although definitive conclusions will require additional years of data, the plateau in early stage disease might portend stabilization in the overall incidence of esophageal adenocarcinoma.
authors.affiliation: The VA Outcomes Group, Veterans Affairs Medical Center, White River Junction, Vermont 05009, USA. heiko.pohl@dartmouth.edu
authors.forename: Heiko
authors.initials: H
authors.lastname: Pohl
authors.forename: Brenda
authors.initials: B
authors.lastname: Sirovich
authors.forename: H Gilbert
authors.initials: HG
authors.lastname: Welch
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009367:Neoplasm Staging; D012307:Risk Factors; D018426:SEER Program