Esophageal CA and Barrett Esophagus Increasing in Middle-Aged Adults

Adults aged 45 to 64 years had nearly a 2-fold increased rate of esophageal cancer (EC) and a 50% increased rate of Barrett esophagus (BE) from 2012 to 2019, according to study results presented at Digestive Disease Week (DDW), held from May 21 to 24, 2022, in San Diego, California, and virtually.

Investigators sought to determine the prevalence of BE and EC according to age. Using electronic health records from the OneFlorida Clinical Data Research Network, researchers identified patients diagnosed with EC and BE from 2012 to 2019, using International Classification of Disease (ICD)-9 and ICD-10 codes.

The primary outcome was the prevalence of BE and EC, which was adjusted per 100,000 patients. Researchers categorized age into 3 groups: young patients (aged 18-44 years), middle-aged patients (aged 45-64 years), and older adults (aged >65 years). Regression analysis was used to assess the association between risk factors and BE.

The number of adult patients in the database ranged annually from 4,238,884 to 5,411,838. In 2019, 57.1% (n=2,964,538) were women, 40% (n=2,068,086) were White, and 22.2% (n=5,188,036) were Black.

While EC prevalence varied significantly in each age group, EC rates were higher in the older adult group compared with the middle-aged group each year (P <.0001). EC prevalence was stable from 2012 to 2019 in the older adult group, but it increased logarithmically from 49 per 100,000 patients in 2012 to 94 per 100,000 patients in 2019 in the middle-aged group.

BE prevalence in the middle-aged group also increased logarithmically from 304 per 100,000 patients in 2012 to 466 per 100,000 patients in 2019. The increased rate of BE prevalence was highest in those aged 51 to 60 years, followed by those aged 61 to 70 years and those aged 41 to 50 years. Use of esophagogastroduodenoscopy was stable from 2012 to 2019.

The researchers noted that their study was not a randomized controlled trial and included only adults living in Florida. Also, the data were only from patients who visited hospitals or doctors’ offices, so it is unclear whether individuals currently or previously had a disease at time of visit.

“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 Bashar J. Qumseya, lead study author, said in a DDW 2022 news release. “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.”

Reference

1. Qumseya BJ, Salloum R. Alarming increase in prevalence of esophageal cancer and Barrett’s esophagus in middle-aged patients: findings from a statewide database of over five million patients. Presented at: DDW 2022; May 21-24, 2022; San Diego, CA. Abstract 671.
2. Alarming rise found in esophageal cancer and Barrett’s esophagus in middle-aged adults: Researchers say findings suggest urgent need for earlier endoscopic screening. News release. DDW 2022. May 13, 2022.

This article originally appeared on Gastroenterology Advisor