title: Exploring the recent trend in esophageal adenocarcinoma incidence and mortality using comparative simulation modeling.
abstract: BACKGROUND
  The incidence of esophageal adenocarcinoma (EAC) has increased five-fold in the United States since 1975. The aim of our study was to estimate future U.S. EAC incidence and mortality and to shed light on the potential drivers in the disease process that are conduits for the dramatic increase in EAC incidence.
  
  
  METHODS
  A consortium of three research groups calibrated independent mathematical models to clinical and epidemiologic data including EAC incidence from the Surveillance, Epidemiology, and End Results (SEER 9) registry from 1975 to 2010. We then used a comparative modeling approach to project EAC incidence and mortality to year 2030.
  
  
  RESULTS
  Importantly, all three models identified birth cohort trends affecting cancer progression as a major driver of the observed increases in EAC incidence and mortality. All models predict that incidence and mortality rates will continue to increase until 2030 but with a plateauing trend for recent male cohorts. The predicted ranges of incidence and mortality rates (cases per 100,000 person years) in 2030 are 8.4 to 10.1 and 5.4 to 7.4, respectively, for males, and 1.3 to 1.8 and 0.9 to 1.2 for females. Estimates of cumulative cause-specific EAC deaths between both sexes for years 2011 to 2030 range between 142,300 and 186,298, almost double the number of deaths in the past 20 years.
  
  
  CONCLUSIONS
  Through comparative modeling, the projected increases in EAC cases and deaths represent a critical public health concern that warrants attention from cancer control planners to prepare potential interventions.
  
  
  CONCLUSIONS
  Quantifying this burden of disease will aid health policy makers to plan appropriate cancer control measures. Cancer Epidemiol Biomarkers Prev; 23(6); 997-1006. ©2014 AACR.
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the NetherlandsAuthors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the Netherlands joey@mgh-ita.org.
authors.forename: Chung Yin
authors.initials: CY
authors.lastname: Kong
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Sonja
authors.initials: S
authors.lastname: Kroep
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Kit
authors.initials: K
authors.lastname: Curtius
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: William D
authors.initials: WD
authors.lastname: Hazelton
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Jihyoun
authors.initials: J
authors.lastname: Jeon
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Rafael
authors.initials: R
authors.lastname: Meza
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the NetherlandsAuthors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Curtis R
authors.initials: CR
authors.lastname: Heberle
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the NetherlandsAuthors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Melecia C
authors.initials: MC
authors.lastname: Miller
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the NetherlandsAuthors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Choi
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Iris
authors.initials: I
authors.lastname: Lansdorp-Vogelaar
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: van Ballegooijen
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Feuer
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: John M
authors.initials: JM
authors.lastname: Inadomi
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the NetherlandsAuthors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the NetherlandsAuthors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Depart
authors.forename: Chin
authors.initials: C
authors.lastname: Hur
authors.affiliation: Authors' Affiliations: Institute for Technology Assessment; Gastrointestinal Unit, Massachusetts General Hospital; Harvard Medical School, Boston, Massachusetts; Department of Applied Mathematics; Division of Gastroenterology, School of Medicine, University of Washington; Program in Biostatistics and Biomathematics; Program in Computational Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; and Department of Public Health, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: E Georg
authors.initials: EG
authors.lastname: Luebeck
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000401:mortality; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008962:Models, Theoretical