Background: Esophageal, gastric and gastroesophageal (GE) junction carcinomas have clearly had different trends of incidence over the the past two decades in the world, especially in the United States. What is more alarming is the histological type of subsite cancer appears to be changing and may also differ according to ethnicity and gender as well. The authors examined incidence patterns among Caucasians (C), African Americans (AA) and Asian/Pacific Islanders (API).

Methods: We used data from the Surveillance Epidemiology and End Results (SEER) database of the National Cancer Institute. SEER 9 data was used to identify all patients who were diagnosed with esophageal, stomach and GE junction carcinomas between 1975 and 2006. Age-adjusted rates and age specific rates were computed by anatomic subsite, histology, race, and gender. Incidence trend patterns were analyzed accordingly.

Results: Major differences were seen for the distribution of esophageal cancer based on subsite, histology and ethnicity. White males had the predominant histology adenocarcinoma in the distal esophagus (83.9%) compared to AA having squamous cell carcinoma (63.8%) and API having similar distribution of both adenocarcinoma (43.6%) and squamous (48%). This trend was not seen in white females. In Caucasian men, adenocarcinoma of the distal esophagus is now outnumbering adenocarcinoma of the stomach. This trend is not seen in any other ethnic and/or gender group. For stomach cancer, white males had more proximal tumors compared to black males. Black males were diagnosed with distal tumors compared to white males.

Conclusions: There are large differences in incidence trends according to ethnicity, gender, anatomic subsite and histology. The variation in cancer incidence patterns by race does not seem to be completely explained or accounted for by differences in known risk factors.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A107.