The incidence of esophageal cancer in middle-aged adults nearly doubled from 2012 to 2019, according to a study of more than 5 million Florida residents. 

As there was no increase in esophagogastroduodenoscopy during the study period, the researchers concluded that these data reflect a true increase in the prevalence of esophageal cancer.

“Whenever we see increasing prevalence of any type of cancer, we should ask whether this is merely due to better screening or it is a true increase in the disease prevalence. In our study, it was due to the latter,” Bashar J. Qumseya, MD, of the University of Florida in Gainesville, said in a press release.1


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Dr Qumseya presented results from this study in a press briefing in advance of Digestive Disease Week 2022. The full results are scheduled to be presented at the meeting later this month.2 

Dr Qumseya and colleagues evaluated the prevalence of esophageal cancer and Barrett’s esophagus using electronic health record data from the OneFlorida Clinical Data Research Network. 

The number of patients in the database varied from year to year, but the range was 4,238,884 to 5,411,838. The patients were categorized into 3 groups according to age: young patients (18-44 years), middle-aged (45-64 years), and elderly (≥65 years). 

The prevalence of esophageal cancer was significantly higher in the elderly group than in the middle-aged group (P <.0001). However, the prevalence remained stable over time in the elderly group and increased in the middle-aged group.

Among middle-aged patients, the prevalence of esophageal cancer increased from 49 per 100,000 patients in 2012 to 94 per 100,000 patients in 2019. The middle-aged group also saw an increase in the prevalence of Barrett’s esophagus, from 304 per 100,000 patients in 2012 to 466 per 100,000 patients in 2019.

“This strong growth in prevalence should be of concern to physicians, and we should consider screening more middle-aged patients for esophageal cancer if they are at higher risk,” Dr Qumseya said.1 

“From other analyses we have conducted with this dataset, we know that even patients with 4 or more risk factors for esophageal cancer are not having endoscopies,” he added. “So, from both the patient and provider perspective, we can do better.”

“Many patients in the US now have colonoscopies starting at age 45, so conducting an endoscopy at the same time, among those with multiple risk factors, could help capture more patients with Barrett’s esophagus and esophageal cancer,” he concluded.

References

1. Alarming rise found in esophageal cancer and Barrett’s esophagus in middle-aged adults. News release. EurekAlert. Published May 13, 2022. Accessed May 16, 2022. 

2. Qumseya C, Salloum R. Alarming increase in prevalence of esophageal cancer and Barrett’s esophagus in middle-aged patients: Findings from a statewide database of over 5 million patients. To be presented at Digestive Disease Week 2022; May 21-23, 2022. Abstract 671.