Increased incidence and survival for oesophageal cancer but not for gastric cardia cancer in the Netherlands.
BACKGROUND
A worldwide increasing incidence is seen for oesophageal adenocarcinoma, but not for oesophageal squamous cell carcinoma (SCC) and gastric cardia adenocarcinoma. Purposes of the current study were to evaluate the changing incidence rates of oesophageal and gastric cardia cancer, and to assess survival trends.


METHODS
Patients diagnosed with oesophageal adenocarcinoma (N=12,195) or SCC (N=9046), or gastric cardia adenocarcinoma (N=9900) between 1989 and 2008 in the Netherlands were included. Changes in European Standard Population (ESP) and relative survival over time were evaluated.


RESULTS
Incidence rates for oesophageal adenocarcinoma increased in males (+7.5%, P<0.001) and females (+5.2%, P<0.001), while the incidence for oesophageal SCC remained stable in males (-0.2%, P=0.6) and slightly increased in females (+1.7%, P=0.001). The incidence for gastric cardia cancer decreased in males (-1.2%, P<0.006), and remained stable in females (-0.2%, P=0.7). Five-year survival for both M0 and M1 oesophageal carcinoma doubled over the last 20 years. No significant changes in survival were found for M0 and M1 gastric cardia carcinoma.


CONCLUSIONS
In the Netherlands, a rising incidence is seen for oesophageal adenocarcinoma, but not for gastric cardia adenocarcinoma. This finding most likely reflects true changes in disease burden, rather than being the result of changes in diagnosis or classification. The increased survival for oesophageal carcinoma can be attributed to centralisation of surgery, and an increased use of multimodality therapy, factors hardly acknowledged for gastric cancer.
Department of Surgery, K6-R, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. j.l.dikken@lumc.nl
Johan L
JL
Dikken
Valery E
VE
Lemmens
Michel W J M
MW
Wouters
Bas P
BP
Wijnhoven
Peter D
PD
Siersema
Grard A
GA
Nieuwenhuijzen
Johanna W
JW
van Sandick
Annemieke
A
Cats
Marcel
M
Verheij
Jan Willem
JW
Coebergh
Cornelis J H
CJ
van de Velde
D000230:Adenocarcinoma / Q000453:epidemiology* / Q000401:mortality; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000401:mortality; D002299:Cardia; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000401:mortality; D013997:Time Factors