Demographic analysis of survival trends in squamous cell carcinoma of the upper 1/3 of the esophagus: a population-based study.

Abstract

Esophageal malignancies, constituting 3% of global cancers, pose significant health challenges with poor survival rates. Squamous Cell Carcinoma (SCC) and Adenocarcinoma (AC) are predominant subtypes, with shifting incidences globally. This analysis will focus primarily on the demographics of survival trends for Squamous cell carcinoma of esophagus (SCCE). This retrospective study, utilizing the SEER database, examined demographic factors influencing survival trends in SCC of the upper esophagus. Variables included age, sex, race, income, and rurality. Statistical analyses included chi-square tests and multivariable models, specifically logistic regression and conditional inference tree models. A total of 2821 patients were included in this study. Demographic disparities were evident with race (p < 0.001), age (p = 0.002), and sex (p = 0.048) significantly impacting survival when holding other variables constant, with Non-Hispanic Black individuals exhibiting the greatest odds of mortality compared to other racial groups. Median household income (p = 0.344) and Rural-Urban Continuum (p = 0.100) were not significantly associated with improved survival rates when controlling for other demographics. Our findings align with previous research on sex-based survival disparities and racial variations in SCCE incidence and outcomes. Socioeconomic and biological factors contribute to these disparities, highlighting the need for tailored interventions and equitable healthcare access. Understanding demographic determinants in SCCE survival is crucial for personalized treatment and policy reforms to address disparities. Future research should focus on prospective, diverse cohorts to further elucidate these complex interactions and improve esophageal SCCE management and outcomes.