Demographic Trends of Esophageal Carcinoma in India Along with a Brief Comparative Review of the Global Trends

Abstract

Abstract Background Esophageal cancers (ECs) are more prevalent in the East Asian countries of the world, wherein squamous cell carcinomas (SCCs) are the predominant histological subtype. In contrast, the patterns in the west are a bit heterogeneous, with esophageal adenocarcinoma (AC) being the more frequent histological subtype. There are very sparse published Indian data pertaining to the demographic trends of ECs. Materials and Methods Our study was a retrospective analysis of the demographic trends of 917 patients of ECs who were managed at our center over a 10-year period. Results and Discussion EC accounted for nearly 4.1% of the total cancer burden managed at our center during January 2002 to December 2011. The mean age of our patient cohort was 54.2 years. The male:female ratio was nearly 1.7:1. Tobacco chewing was noted in 25.4%, smoking in 37%, whereas alcohol consumption was noted in ~20% of the patients. SCC was the most common histological subtype (78.3%), whereas ACs constituted only 9.9%. Eighty-nine per cent of the tumors in our patient cohort were locally advanced. Definitive chemoradiation was the most common modality of definitive management then; however, over the years, our preferred choice of the management of ECs has shifted to neoadjuvant chemoradiation followed by surgery in the carefully selected patients of locally advanced resectable ECs. Conclusion Our study clearly shows SCC to be the most common histological subtype among ECs, a trend that has been observed in the vast majority of the East Asian nations. The epidemic rise in the incidence of esophageal ACs as seen in the west is not seen in our study. Periodic monitoring of the demographic trends of ECs is of great importance both for clinicians and policymakers. We hope that our study will enlighten both policyholders and clinicians to better channelize the efforts toward prevention and more effective management of this deadly cancer.