Esophageal carcinoma: An epidemiological analysis and study of the time trends over the last 20 years from a single center in India

Abstract

Aims: Esophageal carcinoma is a common gastrointestinal malignancy. The aim of the study was to evaluate the time trends over 20 years and observe how they differ from the West. Materials and Methods: The study was conducted at SKIMS Regional Cancer Centre in Radiation Oncology Department. This was a retrospective study. Retrospective analysis was carried out from records available at the Regional Cancer Center from 1993 to 2013. The case records of 2090 patients with histological proven squamous and adenocarcinoma (AC) of the esophagus were studied in terms of age, sex, risk factors, and mode of presentation. Results: Data of 2190 patients with esophageal cancer were retrieved. Out of 2190 patients, group A included 1060 and group B had 1130 patients. The mean age at presentation was 59 years in both groups. Five hundred and thirty-eight (56.4%) were male and 477 (43.6%) were females in group A, whereas in group B, 615 were male and 515 were female. Most of the patients presented with dysphagia 2139 (97.67%). In group A, 1030 (97.16%) presented with dysphagia, whereas 1090 (96.46%) presented with dysphagia in group B. Most of the patients had lesion in middle 3rd of esophagus, 849 (80%) in group A whereas 903 (79.9%) in group B. Squamous cell carcinoma (SCC) was the most common histology in both groups, 1010 (95.2%) in group A whereas 1060 (93.8%) in group B. Most common appearance was proliferative (37.7% in group A and 37.6% in group B). Most of the patients were salt tea takers in both groups (98.11% in group A and 97.34% in group B). Conclusion: Our study suggests that esophageal cancer occurs a decade earlier in India. It affects males more than females. SCC is still the most common histological subtype and is way ahead of AC. The mid esophagus is still the most common site. There is no evidence of an increase in the rate of lower esophageal malignancy in our study as opposed to western literature.