S881 Temporal Trends in Prevalence and Mortality of Esophageal Cancer: A 14-Year Analysis Multicenter Retrospective Study

Introduction: Esophageal cancer is a relatively rare but deadly malignancy with rising mortality and poor prognosis, often diagnosed at late stages. Unlike other cancers with declining trends, its epidemiology remains unclear. Using TriNetX data from 145 U.S. healthcare organizations (2010-2024), this study examines temporal trends in esophageal cancer prevalence, mortality, and patient characteristics to better understand its evolving clinical impact. Methods: This is a retrospective study utilizing TriNetX database for the years 2010-2024 was queried to identify adult (age >18 years) patients admitted with the principal procedural codes for esophageal cancer. Data were obtained from 145 health care organizations in the U.S. that contributed to the TriNetX database. We estimated trends in the total number of patients yearly, prevalence, and mortality rate for patients admitted for esophageal cancer. Results: A total of 152,802 patients had esophageal cancer, 54,427 of which died. From 2010 to 2024, the prevalence of esophageal cancer has increased from 0.035% in 2010 to 0.076% in 2024 (P < 0.01), mortality rate has increased from 3.9% to 11.603% (P < 0.01), mean age decreased from 74 years to 72 years (P < 0.01). The average mortality rate over this timeframe was 35.6%. Ten point seven percent had a body mass index >30, prevalence of gastroesophageal reflux disease was 36.7%, prevalence of Barrett esophagus 15.3%, alcohol was 20.2% and tobacco use was 16.9%. The average mortality rate over 5 years was 35.6%. Prevalence of the lower third of the esophagus has increased significantly from 6.3% to 40.7%, middle third of esophagus has increased from 3.6% to 13.2%, upper third of esophagus has increased from 3.4% to 10.1%. Conclusion: From 2010 to 2024, esophageal cancer in the U.S. showed a significant rise in prevalence and mortality, with a younger mean age at diagnosis. Increases were also noted in tumors of all esophageal regions, especially the lower third. These findings highlight the need for earlier detection strategies, risk factor mitigation, and improved clinical interventions to address the growing burden of esophageal cancer.