Trends in incidence and survival of esophageal cancer in Korea: Analysis of the Korea central cancer registry database

Background and Aim: The diagnostic and therapeutic modalities of esophageal cancer have recently improved in Asia, and its prognosis is expected to change. This study provides a population-based report on the epidemiology of esophageal cancer in Korea. Methods: Cancer incidence data from 1999 to 2013 were obtained from the Korea Central Cancer Registry, covering the entire population. Age-standardized incidence rates and annual percent changes were calculated according to subsites and histological types. Five-year relative survival rates were estimated for cases diagnosed between 1993 and 2013. Relative excess rates were compared between patients diagnosed from 2009 to 2013 and 2006 to 2008. Results: The age-standardized incidence rates decreased from 8.8 per 100 000 populations in 1999 to 5.9 in 2013 with an annual percent change of 2.6% in men and 2.2% in women. The most common histological type was squamous cell carcinoma, accounting for 90.2% of all esophageal cancers in 2013, followed by adenocarcinomas (3.1%), and their incidences decreased. The proportion of localized and regional cancer tended to increase compared with that of distant cancer. Five-year relative survival of squamous cell carcinoma improved from 12.1% (1993–1995) to 34.6% (2009–2013). Relative excess rate was 0.72 (95% confidence interval 0.65–0.80) in localized stage and 0.88 (95% confidence interval, 0.82–0.95) in regional stage comparing patients diagnosed from 2009 to 2013 and 2006 to 2008. Conclusions: The incidence of esophageal cancer has decreased in Korea for the past 15 years, and 5-year survival rates have improved significantly. These increases may be attributable to more effective detection of early-stage disease.