title: Epidemiology and risk factors for oesophageal adenocarcinoma.
abstract: Oesophageal adenocarcinoma will soon cease to be a rare form of cancer for people born after 1940. In many Western countries, its incidence has increased more rapidly than other digestive cancers. Incidence started increasing in the Seventies in England and USA, 15 years later in Western Europe and Australia. The cumulative risk between the ages of 15 and 74 is particularly striking in the UK, with a tenfold increase in men and fivefold increase in women in little more than a single generation. Prognosis is poor with a 5-year relative survival rate of less than 10%. The main known risk factors are gastro-oesophageal reflux, obesity (predominantly mediated by intra-abdominal adipose tissues) and smoking. Barrett's oesophagus is a precancerous lesion, however, the risk of degeneration has been overestimated. In population-based studies the annual risk of adenocarcinoma varied between 0.12% and 0.14% and its incidence between 1.2 and 1.4 per 1000 person-years. Only 5% of subjects with Barrett's oesophagus die of oesophageal adenocarcinoma. On the basis of recent epidemiological data, new surveillance strategies should be developed. The purpose of this review is to focus on the epidemiology and risk factors of oesophageal adenocarcinoma.
authors: Burgundy Digestive Cancer Registry, INSERM U866, 21079 Dijon Cedex, France. come.lepage@u-bourgogne.fr
authors: Côme
authors: C
authors: Lepage
authors: Antoine
authors: A
authors: Drouillard
authors: Jean-Louis
authors: JL
authors: Jouve
authors: Jean
authors: J
authors: Faivre
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D017677:Age Distribution; D001471:Barrett Esophagus / Q000150:complications; D015992:Body Mass Index; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D005764:Gastroesophageal Reflux / Q000150:complications; D014943:Global Health; D006801:Humans; D015994:Incidence; D056128:Obesity, Abdominal / Q000150:complications; D011379:Prognosis; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects; D015996:Survival Rate
keywords: Barrett's oesophagus; Incidence; Oesophageal adenocarcinoma; Risk factors; Survival