Esophageal and Gastric Cancer and Risk Factors: Population temporal trends in the Surveillance, Epidemiology and End Results Program, and National Health and Nutrition Examination Survey
Background: Esophageal and gastric cancers have a high incidence and mortality in the US. Understanding the risk factors and trends associated with these cancers is crucial for developing effective prevention strategies.Objective: This descriptive study analyzed time trends for esophageal and gastric cancer incidence and related modifiable risk factors.Methods: Data from the Surveillance, Epidemiology, and End Results Survey Program (1975-2020), and the National Health and Nutrition Examination Survey (1988-2018) were used. Temporal trends in incidence rates and risk factor prevalence were determined, including for groups defined by sex, race, and subtype.Results: Esophageal squamous cell carcinoma rates declined, particularly among Black males (from 16.1 to 1.5 per 100,000), while esophageal adenocarcinoma rates increased among White males (from 0.7 to 4.3 per 100,000). Cardia gastric cancer rates remained stable, with higher incidence among males (average 3.1 per 100,000 compared to 0.7 per 100,000), whereas non-cardia gastric cancer incidence decreased for all. The percentage of the population that was overweight/obese increased from 52.4% to 73.8%. In contrast, prevalence of heavy alcohol drinking and current smoking decreased while the prevalence of inadequate intakes of nutrients such as calcium, particularly folate, significantly improved. Recently, inactivity prevalence has decreased, but >50% of the population remains physically inactive.Conclusion: Trends in modifiable lifestyle factors, such as increased obesity, reduced heavy alcohol consumption, and changing dietary habits, could explain some of the observed trends in esophageal and gastric cancer rates. Therefore, continued public health efforts are needed to address modifiable risk factors and reduce cancer incidence..