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Oesophagus
Original research
International trends in oesophageal cancer survival by histological subtype between 1995 and 2014
  1. Eileen Morgan1,2,
  2. Isabelle Soerjomataram1,
  3. Anna T Gavin2,
  4. Mark J Rutherford3,
  5. Piers Gatenby4,
  6. Aude Bardot1,
  7. Jacques Ferlay1,
  8. Oliver Bucher5,
  9. Prithwish De6,
  10. Gerda Engholm7,
  11. Christopher Jackson8,9,
  12. Serena Kozie10,
  13. Alana Little11,
  14. Bjorn Møller12,
  15. Lorraine Shack13,
  16. Hanna Tervonen11,
  17. Vicky Thursfield14,
  18. Sally Vernon15,
  19. Paul M Walsh16,
  20. Ryan R Woods17,
  21. Christian Finley18,
  22. Neil Merrett19,
  23. Dianne L O’Connell20,
  24. John V Reynolds21,
  25. Freddie Bray1,
  26. Melina Arnold1
  1. 1 Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
  2. 2 Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, UK
  3. 3 Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK
  4. 4 Department of Clinical and Experimental Medicine, University of Surrey, Guildford, Surrey, UK
  5. 5 Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada
  6. 6 Surveillance and Cancer Registry, Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
  7. 7 Cancer Surveillance and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
  8. 8 Cancer Society of New Zealand, Wellington, New Zealand
  9. 9 Department of Medicine, Otago Medical School, Dunedin, New Zealand
  10. 10 Saskatchewan Cancer Agency, Regina, Saskatchewan, Canada
  11. 11 Cancer Information and Analysis, Cancer Institute NSW, Alexandria, New South Wales, Australia
  12. 12 Department of Registration, Cancer Registry of Norway, Oslo, Norway
  13. 13 Cancer Control Alberta, Alberta Health Services, Edmonton, Alberta, Canada
  14. 14 Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Victoria, Australia
  15. 15 National Cancer Registration and Analysis Service, Public Health England, Cambridge, UK
  16. 16 National Cancer Registry Ireland, Cork, Ireland
  17. 17 BC Cancer Agency, Vancouver, British Columbia, Canada
  18. 18 Department of Surgery, McMaster University, Hamilton, Ontario, Canada
  19. 19 School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
  20. 20 Cancer Research Division, Cancer Council NSW, Sydney, New South Wales, Australia
  21. 21 National Centre for Oesophageal Cancer, St James’s Hospital and Trinity College Dublin, Dublin, Ireland
  1. Correspondence to Dr Eileen Morgan, Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France; morgane{at}fellows.iarc.fr

Abstract

Introduction Survival from oesophageal cancer remains poor, even across high-income countries. Ongoing changes in the epidemiology of the disease highlight the need for survival assessments by its two main histological subtypes, adenocarcinoma (AC) and squamous cell carcinoma (SCC).

Methods The ICBP SURVMARK-2 project, a platform for international comparisons of cancer survival, collected cases of oesophageal cancer diagnosed 1995 to 2014, followed until 31st December 2015, from cancer registries covering seven participating countries with similar access to healthcare (Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK). 1-year and 3-year age-standardised net survival alongside incidence rates were calculated by country, subtype, sex, age group and period of diagnosis.

Results 111 894 cases of AC and 73 408 cases of SCC were included in the analysis. Marked improvements in survival were observed over the 20-year period in each country, particularly for AC, younger age groups and 1 year after diagnosis. Survival was consistently higher for both subtypes in Australia and Ireland followed by Norway, Denmark, New Zealand, the UK and Canada. During 2010 to 2014, survival was higher for AC compared with SCC, with 1-year survival ranging from 46.9% (Canada) to 54.4% (Ireland) for AC and 39.6% (Denmark) to 53.1% (Australia) for SCC.

Conclusion Marked improvements in both oesophageal AC and SCC survival suggest advances in treatment. Less marked improvements 3 years after diagnosis, among older age groups and patients with SCC, highlight the need for further advances in early detection and treatment of oesophageal cancer alongside primary prevention to reduce the overall burden from the disease.

  • cancer epidemiology
  • cancer registries
  • oesophageal cancer
  • histopathology

https://doi.org/10.1136/gutjnl-2020-321089

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    Footnotes

    • Twitter @EileenMorgan_

    • Contributors Study concept and design: EM, IS, FB, MA. Data collection and interpretation of data: HT, LS, RW, SK, AL, PD, VT, GE, AG, EM, PW, SV, CJ, BM, OB. Data analysis: EM, MR, AB, JF. Drafting the manuscript: EM, IS, MA. Critical revision of the manuscript for important intellectual content: all authors.

    • Funding The ICBP is funded by the Canadian Partnership Against Cancer; Cancer Council Victoria; Cancer Institute New South Wales; Cancer Research UK; Danish Cancer Society; National Cancer Registry Ireland; The Cancer Society of New Zealand; NHS England; Norwegian Cancer Society; Public Health Agency Northern Ireland, on behalf of the Northern Ireland Cancer Registry; The Scottish Government; Western Australia Department of Health; Wales Cancer Network. Where authors are identified as personnel of the International Agency for Research on Cancer/WHO, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy or views of the International Agency for Research on Cancer/WHO.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Ethics approval Ethical approval was obtained from the International Agency for Research on Cancer (IARC) Ethics Committee, as well as from the relevant ethics committees in each participating jurisdiction, as required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available.