S1071 Radical Racial and Gender-Wise Differences in Esophageal Adenocarcinoma (EAC)

Introduction: Esophageal adenocarcinoma (EAC) is the most common form of esophageal cancer in the Western world, with its incidence increasing in recent decades. EAC typically develops from a condition known as Barrett's esophagus, where the normal squamous cells of the esophagus are replaced by abnormal columnar cells due to chronic acid reflux or gastroesophageal reflux disease (GERD). EAC is now the most common type of esophageal cancer in the U.S., surpassing squamous cell carcinoma. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) 22 registry database, we studied EAC trends from 2001-2021 based on incidence and incidence-based mortality (IBM). SEER*Stat 8.4.4 was used to get age-adjusted rates for different years based on gender and race. Joinpoint Regression Program, Version 5.3.0.0. November 2024 was used to analyze the linear regression model. Results: Esophageal adenocarcinoma incidence and mortality rates show distinct demographic trends. Incidence rates among men fluctuated, rising 2.29% annually (2001-2008), declining 3.15% (2008-2011), then increasing 0.48% (2011-2021). Women experienced a steady 0.7% annual rise throughout. Racial disparities persisted, with White populations having the highest rates, though American Indian/Alaska Natives saw the sharpest recent increase (1.6% annually vs 1% in Whites and 1.3% in Asian/Pacific Islanders). IBM rates were consistently higher in men, rising 2% annually (2015-2021) compared to 1.3% in women. White populations had the highest mortality, but Black populations faced a 10.4% annual increase (2018-2021), while American Indian/Alaska Natives experienced a sustained 2.8% annual rise (2001-2021). All trends were statistically significant (P < 0.05). Conclusion: In conclusion, the incidence and IBM rates for esophageal adenocarcinoma exhibit significant variations across gender, race, and time periods. Men, particularly within the White population, experienced higher incidence rates, with recent increases observed in American Indian/Alaska Native populations. While the IBM is notably higher in men, there has been a concerning rise in mortality rates among both men and women, especially among the Black and American Indian/Alaska Native populations. These trends underscore the urgent need for targeted prevention, early detection, and intervention strategies, particularly for high-risk groups, to mitigate the growing burden of esophageal adenocarcinoma.