The incidence of esophageal adenocarcinoma in the western world has been rapidly increasing.
The trends in obesity and other lifestyle-associated factors have been hypothesized to be important drivers of this increase.
Dr Kroep and colleagues tested this hypothesis by comparing changes in these factors with changes in esophageal adenocarcinoma incidence over time between 3 western countries.
Data on esophageal adenocarcinoma incidence trends were abstracted from the SEER-9 registry for the United States, from multiple cancer registries in Spain, and from Eindhoven Cancer Registry in the Netherlands.
In addition, the research team collected trend data on obesity, smoking, and alcohol consumption.
|For alcohol, the highest consumption rates are seen in Spain|
|American Journal of Gastroenterology|
The trend data were analyzed using log-linear regression.
In 1980, the team noted that the esophageal adenocarcinoma incidence was similar among the 3 countries.
The research team found that the esophageal adenocarcinoma incidence increased in all, with the largest increase observed in the Netherlands, followed by the United States and Spain.
However, this pattern was not observed in lifestyle factors associated with esophageal adenocarcinoma.
With regards to obesity, the team found that the United States clearly has had the highest prevalence rates both in the past and in the present.
For alcohol, the highest consumption rates are seen in Spain.
Smoking showed a reverse trend compared with esophageal adenocarcinoma among all 3 countries in the last 20 years.
Dr Kroep's team comments, "International trends in esophageal adenocarcinoma incidence do not match corresponding trends in lifestyle-associated factors including obesity."
"Our findings suggest that factors other than obesity must be the important drivers for the increase in esophageal adenocarcinoma incidence."