A Preliminary Investigation on Birthplace Distribution among Esophageal Cancer Cases from Nine SEER

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A Preliminary Investigation on Birthplace
Distribution among Esophageal Cancer Cases from
Nine SEER Registries, 1973-2004

• Xuguang (Grant) Tao, MD , Ph.D., CTR
• Genevieve M Matanoski, MD, Dr. PH, CTR
• Arron Adade, Ph.D.
• Linda Schwartz, CTR
• Kathy Davis

Johns Hopkins University and DC Cancer Registry
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Background

• Incidence of esophageal cancer has been
  increasing slowly among white males while
  decreasing dramatically among black males in US
  for the past 20 years.
• Incidence of esophageal cancer varies
  considerably according to geographic locations in
  the world. This cancer is much more common in
  areas such as northern Iran and southern
  republics of the former Soviet Union or so called
  Esophageal Cancer Belt.
• It is not clear if the immigrants from areas with
  much higher incidences have had any impact on
  esophageal cancer patterns especially among white
  males in US since esophageal cancer once was a
  relatively rare cancer site in US among white
  males.

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The origins from which white Americans may come

• http//en.wikipedia.org/

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The Central Asian Esophageal Cancer Belt
Extending from Iran to China

• Kamangar F, et al. 2006

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Objectives

• To examine if the increasing trend of esophageal
  cancer incidence rate among white males in US
  correlates to the distribution trend of foreign
  born cases for the last 30 years.

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Method

• To compare the trend of age adjusted esophageal
  cancer incidence rates with the distribution
  trend of foreign born cases among all US
  esophageal cancer cases by gender, race, and
  histology over time (1973-2004) .
• To compare the histology distribution of US born
  esophageal cancer cases with foreign born cases.
• SEER 9 Registry 1973-2004 public-use database and
  SEERstat software were used.

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Esophageal Cancer Incidence Rate (1/100,000) by
Gender and Race, SEER 9 Registries, 1973-2004
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Esophageal Cancer Incidence Rate by Gender, Race,
and Histology, SEER 9, 1973-2004
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White Male Esophageal Cancer Incidence Rate by
Histology, 1973-2004
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Percentage of Selected Foreign Born Esophageal
Cancer Cases, White Males, SEER 9, 1973-2002
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Percentage of Adenocarcinoma of White Male
Esophageal Cancer, SEER 9, 1973-2004

• Differences are all statistically significant at
  Plt0.05 compared to US born cases

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Discussion

• This analysis showed that the changing trend of
  percentages of foreign born esophageal cancer
  cases (such as born in Europe, south America, and
  Asia) did not match the increasing trend of
  esophageal cancer incidence rate observed among
  US white males.
• The proportion of adenocarcinoma among
  foreign-born cases was significantly smaller than
  US born cases so that it could not explain the
  increase of adenocarcinoma among US white males.

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Conclusion

• The increasing trend of esophageal cancer among
  white males in US could not be explained by
  immigration activities based on this preliminary
  investigation