Advanced-stage esophageal adenocarcinoma has been occurring with increased incidence in patients younger than 50 years, according to a recent study published in the journal Cancer Epidemiology, Biomarkers & Prevention.

The study was a population-based analysis of data extracted from the Surveillance, Epidemiology, and End Results 9 database. It included 34,443 patients whose esophageal adenocarcinoma was diagnosed during the years 1975 to 2015. For this age-based analysis of changes in incidence of esophageal adenocarcinoma over time, patients were grouped into 3 categories: younger than 50, 50 to 69, and 70 or older.

Standardized incidence of esophageal adenocarcinoma rose across the entire study period for all age categories, and particularly among patients who were 70 or older. The annual incidence of esophageal adenocarcinoma in patients who were younger than 50 was low across the entire study period, but it rose to a rate of 0.27/100,000 persons in 2015 from 0.08/100,000 in 1975. Advanced disease, which was defined as being regional or distant, was reported at higher rates at presentation in younger patients than in older patients throughout the study period.

A survival analysis of data from 25,813 cases from 1975 to 2011 showed improvements in 5-year disease-free survival during this period for each age group. However, during the years 2000 to 2011, patients younger than 50 showed the lowest rate of disease-free survival (22.9%), compared with the rate of 29.6% seen with each of the 2 older age groups (P <.01).


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Overall survival was consistently best in the age group 50 to 69 years.

“In conclusion, while young-onset esophageal adenocarcinoma remains uncommon, it presents disproportionately with advanced disease (with a worrisome trend of increase over the last 4 decades) and is associated with poorer 5-year esophageal adenocarcinoma-free survival compared with older cohorts,” the researchers concluded in their report.

Disclosures: Multiple authors declared affiliation with the pharmaceutical industry. Please refer to the original article for a full list of disclosures.

Reference

Codipilly DC, Sawas T, Dhaliwal L, et al. Epidemiology and outcomes of young-onset esophageal adenocarcinoma: an analysis from a population-based database. Cancer Epidemiol Biomarkers Prev. Published online December 11, 2020. doi:10.1158/1055-9965.EPI-20-0944