title: Esophageal Adenocarcinoma in Patients Younger than 40 Years: A Two-Decade Experience at a Public and Private Hospital.
abstract: Esophageal adenocarcinoma is typically observed in the older non-Hispanic white population. Changing demographics are altering the epidemiology of the disease. The aim of this study is to review the presentation and outcomes of esophageal adenocarcinoma patients <40 years old at our institution. A retrospective review was performed of patients diagnosed with esophageal adenocarcinoma between 1990 and 2013. Demographics, presentation, and outcomes were compared in those <40 years old and those ≥40 years old. There were 772 total cases with 42 (5%) <40 years old consisting of 37 (88.1%) males, five females and median age of diagnosis of 35 (interquartile range: 31-38). The two most common ethnicities were White non-Hispanic/Latino in 19 (45.2%), Hispanic /Latino in 18 (42.9%). Compared with patients 40 years and older, the younger group had more Hispanic/Latinos than the older group (43% vs 17%, P < 0.001), more frequently presented with stage IV disease (50% vs 29%) and had a shorter median survival. In conclusion, younger patients tend to present at a much later stage than the older counterparts, which may be due to a delay in diagnosis as well as more aggressive biology. Esophageal adenocarcinoma seems to be increasing in the Hispanic/Latino population.
authors.affiliation: Division of Thoracic Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Boys
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Oh
authors.forename: Justin S
authors.initials: JS
authors.lastname: Lewis
authors.forename: Steven R
authors.initials: SR
authors.lastname: DeMeester
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Hagen
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000208:ethnology*; D000328:Adult; D000367:Age Factors; D002140:California / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D016304:Hospitals, Private / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D055815:Young Adult