Trends in oesophageal cancer incidence and mortality in Europe

TLDR

Changes in smoking, alcohol consumption, and possibly diet and physical activity explain the observed trends in oesophageal cancer. The study monitored recent mortality trends from oesophageal cancer in 33 European countries using WHO data and joinpoint regression. The authors also examined incidence rates for different histological types in selected European cancer registration areas. Mortality rates for men in the EU have stayed around 6/100,000 since the early 1980s, with a modest decline in the last decade, while rates in several western, central, and eastern European countries have recently plateaued or fallen; female mortality remains low and stable at ~1.1–1.2/100,000; incidence of adenocarcinoma has risen sharply in northern Europe, surpassing squamous-cell carcinoma in Denmark and Scotland, whereas squamous-cell carcinoma remains dominant in southern Europe.

Abstract

To monitor recent trends in mortality from oesophageal cancer in 33 European countries, we analyzed the data provided by the World Health Organization over the last 2 decades, using also joinpoint regression. For selected European cancer registration areas, we also analyzed incidence rates for different histological types. For men in the European Union (EU), age-standardized (world population) mortality rates were stable around 6/100,000 between the early 1980s and the early 1990 s, and slightly declined in the last decade (5.4/100,000 in the early 2000s, annual percent change, APC = -1.1%). In several western European countries, male rates have started to level off or decline during the last decade (APC = -3.4% in France, and -3.0% in Italy). Also in Spain and the UK, which showed upward trends in the 1990 s, the rates tended to level off in most recent years. A levelling of rates was observed only more recently in countries of central and eastern Europe, which had had substantial rises up to the late 1990 s. Oesophageal cancer mortality rates remained comparatively low in European women, and overall EU female rates were stable around 1.1-1.2/100,000 over the last 2 decades (APC = -0.1%). In northern Europe a clear upward trend was observed in the incidence of oesophageal adenocarcinoma, and in Denmark and Scotland incidence of adenocarcinoma in men is now higher than that of squamous-cell carcinoma. Squamous-cell carcinoma remained the prevalent histological type in southern Europe. Changes in smoking habits and alcohol drinking for men, and perhaps nutrition, diet and physical activity for both sexes, can partly or largely explain these trends.