EAC rates still rising in Czech Republic

Esophageal adenocarcinoma incidence is still rising about 5% per year in both women and men in the Czech republic, along with use of PPIs.

Cancer Epidemiol. 2020 Nov 5;69:101853.
doi: 10.1016/j.canep.2020.101853. Online ahead of print.

Incidence trends of esophageal cancer in the Czech Republic by histological subtype and stage and prescription rate of acid suppressing drugs

Radek Kroupa  1 , Ivana Katinova  2 , Tomas Pavlik  2 , Lumir Kunovsky  3 , Vladimir Prochazka  4 , Petra Borilova Linhartova  5 , Barbora Packova  6 , Zdenek Kala  4 , Jiri Dolina  6

PMID: 33161372 DOI: 10.1016/j.canep.2020.101853


Background: Incidence of esophageal adenocarcinoma (EAC) associated with gastroesophageal reflux disease has increased substantially in developed countries during the past decades. We aimed to analyze trends in incidence of esophageal cancer (EC) by histological subtypes and trends in acid suppressing drugs prescription in the Czech Republic.

Methods: The incidence of EC by histological subtypes, sex, and stage from 1984-2017 was examined using data from the Czech National Cancer Registry. Defined daily doses of acid inhibiting drugs were analyzed from annual reports by the State Institute for Drug Control.

Results: Age standardized incidence of EAC in men increased annually by 4.88 % with 95 % confidence interval (CI) (4.32, 5.45) from 1984 to 2017, and by 5.11 % (95 % CI, 4.02, 6.20) in women. Squamous cell carcinoma increased annually by 5.52 % (95 % CI, 2.49, 8.64) from 1984 to 1994 with subsequent slower increase by 0.87 % (95 % CI, 0.25, 1.50) from 1994 to 2017. It still represents 50 % of all EC in 2017. The comparable early stages of EAC showed similar annual percentage change of 5.77 %. From 2001 to 2018 the use of proton pump inhibitors increased dramatically from 6.8 to 72.9 defined daily doses per 1000 inhabitants.

Conclusion: The incidence of EAC is still increasing in the Czech Republic, however it represents less than half of ECs. The incidence of squamous cell carcinoma is relatively stable. Broad use of acid suppressing drugs did not seem to impact the incidence of EAC even in early stages.

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