S989 Insights Into Esophageal Cancer: Incidence and Survival Rates—A Twenty-Year Analysis

Introduction: Esophageal cancer (EC) is a significant global health concern, with high mortality rates. This study aims to analyze trends in EC using Surveillance, Epidemiology, and End Results (SEER) data. Methods: Data from the SEER database (1992-2021) were analyzed to determine age-adjusted incidence and survival rates of EC. Temporal trends were evaluated using Joinpoint log-linear regression to estimate average annual percent changes (APC). Poisson regression models were employed to compute incidence and mortality rate ratios (IRRs and MRRs). Results: The incidence of EC is significantly higher in men compared to women (4.1 vs 0.9 per 100,000). Non-Hispanic Whites (NHW) had the highest incidence rates while the non-Hispanic Asian (NHA)/Pacific Islanders (PI) had the lowest (2.7 vs 1.5 per 100,000). Mortality patterns mirrored incidence trends: men experienced higher mortality rates than women (3.4 vs 0.7 per 100,000). Longitudinal analysis revealed a significant decline in EC incidence with a greater reduction among men (APC = -1.14; P < 0.001). Among racial/ethnic groups, non-Hispanic Blacks (NHB) experienced the steepest decline in incidence (APC = -3.27; P < 0.001). Stratification by stage at diagnosis showed that patients with localized disease demonstrated a significant decrease in incidence, with rates dropping from 1% to 0.75% over time (APC [95% CI] = -2.29 [-3.73, -1.11]; P = 0.002). Cancer diagnosed at a distant stage has a 4.5-fold higher incidence compared to the in-situ cases. Men were more likely than women to be diagnosed at regional and distant stages (P < 0.001). Age was a critical determinant of both incidence and mortality. Individuals aged 40-49 had a 5-fold increase in incidence relative to those under 20, and this increased to 16-fold among those aged 50 or older (P < 0.001). Mortality trends followed a similar pattern, compared to individuals under 20, those aged 40-49 had a 3.5-fold increase in mortality, which rose to an 11-fold increase for patients aged 50 years and older (P < 0.001). Across all age categories, women consistently exhibited a 68% reduction in both incidence and mortality compared to men (P < 0.001). Conclusion: EC incidence and mortality are significantly higher among men and increase sharply with age, particularly after 50 years. NHW exhibits the highest incidence rates, while NHA/PI have the lowest. Over time, incidence has declined, most notably among men and NHB. Advanced stage at diagnosis remains more common in men.