title: The Race-Specific Incidence of Esophageal Squamous Cell Carcinoma in Individuals With Exposure to Tobacco and Alcohol.
abstract: The relative impact of esophageal squamous cell carcinoma (ESCC) in minority populations is incompletely understood. We aimed to estimate the race-specific incidences of ESCC and place these in the context of the incidence of esophageal adenocarcinoma (EAC) in white men with gastroesophageal reflux disease (GERD).
  
  
  
  The race- and sex-specific exposures to tobacco and alcohol in the United States were obtained from the National Health Interview Survey. The standardized incidence ratios of exposure to tobacco smoke and/or alcohol for ESCC were estimated from meta-analyses. Existing incidences of ESCC in the United States were obtained from the Surveillance, Epidemiology, and End Results (SEER) program. We then used this data to inform a Markov computer model estimating the incidence of ESCC.
  
  
  
  The incidence of ESCC reported in SEER was the greatest among African-Americans compared with white non-Hispanics, Hispanics, or Asians. In our model, the estimated incidence of ESCC in African-American men exposed to tobacco and alcohol approached the risk of EAC in white non-Hispanic men with weekly GERD. For instance, at age 60 years, the incidence of ESCC in African-American men who have used both tobacco and alcohol was 30/100,000 compared with an incidence of EAC in white men with GERD of 40/100,000. In comparison, the risk of EAC in white non-Hispanic women with weekly GERD at this age was 6.2/100,000.
  
  
  
  The incidence of ESCC in African-American men who use alcohol and tobacco is the highest and comparable to other screened diseases. Development of screening and prevention programs for ESCC in high-risk populations should be considered.
authors: Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan, USA.|Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
authors: Anoop
authors: A
authors: Prabhu
authors: Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University School of Medicine, Columbus, Ohio, USA.
authors: Kenneth
authors: K
authors: Obi
authors: Division of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, Oregon, USA.
authors: David
authors: D
authors: Lieberman
authors: Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan, USA.|Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, Michigan, USA.|Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan, USA.
authors: Joel H
authors: JH
authors: Rubenstein
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000208:ethnology*; D001213:Asian / Q000706:statistics & numerical data; D002294:Carcinoma, Squamous Cell / Q000208:ethnology*; D015897:Comorbidity; D004938:Esophageal Neoplasms / Q000208:ethnology*; D000077277:Esophageal Squamous Cell Carcinoma; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D018426:SEER Program; D012907:Smoking / Q000208:ethnology*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data