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  • Title: The Race-Specific Incidence of Esophageal Squamous Cell Carcinoma in Individuals With Exposure to Tobacco and Alcohol.
    Author: Prabhu A, Obi K, Lieberman D, Rubenstein JH.
    Journal: Am J Gastroenterol; 2016 Dec; 111(12):1718-1725. PubMed ID: 27575710.
    Abstract:
    OBJECTIVES: The relative impact of esophageal squamous cell carcinoma (ESCC) in minority populations is incompletely understood. We aimed to estimate the race-specific incidences of ESCC and place these in the context of the incidence of esophageal adenocarcinoma (EAC) in white men with gastroesophageal reflux disease (GERD). METHODS: The race- and sex-specific exposures to tobacco and alcohol in the United States were obtained from the National Health Interview Survey. The standardized incidence ratios of exposure to tobacco smoke and/or alcohol for ESCC were estimated from meta-analyses. Existing incidences of ESCC in the United States were obtained from the Surveillance, Epidemiology, and End Results (SEER) program. We then used this data to inform a Markov computer model estimating the incidence of ESCC. RESULTS: The incidence of ESCC reported in SEER was the greatest among African-Americans compared with white non-Hispanics, Hispanics, or Asians. In our model, the estimated incidence of ESCC in African-American men exposed to tobacco and alcohol approached the risk of EAC in white non-Hispanic men with weekly GERD. For instance, at age 60 years, the incidence of ESCC in African-American men who have used both tobacco and alcohol was 30/100,000 compared with an incidence of EAC in white men with GERD of 40/100,000. In comparison, the risk of EAC in white non-Hispanic women with weekly GERD at this age was 6.2/100,000. CONCLUSIONS: The incidence of ESCC in African-American men who use alcohol and tobacco is the highest and comparable to other screened diseases. Development of screening and prevention programs for ESCC in high-risk populations should be considered.
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