Esophageal cancer, classified as either esophageal adenocarcinoma (EAC) or esophageal squamous cell carcinoma (ESCC), is the seventh leading cause of death in men in the United States. Two-thirds of esophageal cancers in the United States are EAC.

To gain a comprehensive understanding of esophageal cancer, researchers analyzed data from the United States Cancer Statistics registry, which combines information from two major cancer databases. They also looked at regional differences in esophageal cancer stratified by type (EAC and ESCC).

The researchers found that the incidence of ESCC, which is associated with smoking and alcohol consumption, decreased significantly between 2001 and 2015. Conversely, the incidence of EAC, which typically stems from Barrett’s esophagus and is associated with gastroesophageal reflux disease (GERD) and obesity, increased significantly from 2001 to 2006.

Regionally, the incidence of EAC was highest in the Midwest, and increased most rapidly in the Northeast. The incidence of EAC decreased in the West between 2006 and 2016.

A probable explanation for the decline in ESCC is the steep drop in smoking. This suggests that reducing the risk factors for EAC, such as managing GERD and maintaining a healthy weight, could help prevent EAC. Also, earlier detection is needed since only 24 percent of esophageal cancers were localized to the esophagus when diagnosed.

The study’s complete findings were published online in the Cureus Journal of Medical Science in December 2018.