Prevalence and Age, Gender and Geographical Area Distribution of Esophageal Squamous Cell Carcinomas in North China from 1985 to 2006

Objective: To establish the prevalence and distribution profile of esophageal squamous cell carcinomas(ESCCs) over a 22-yr period in North China.
Methods: Using endoscopy for primary diagnosis and histologicalanalysis for the further confirmation, a total of 74,854 ESCC patients aged 20-89 between January 1985 andDecember 2006 were investigated to analyze the epidemiological profile including prevalence rates, distributionof age-of-onset, gender and geographical area of ESCC in Luoyang, the highest incidence area of North China.
Results: A total of 4092 cases of ESCC were finally diagnosed among 74,854 patients who had their firstendoscopies. The prevalence among males was higher than that among females (p<0.01), resulting in an overallmale:female OR of 1.2 (95%CI, 1.2–1.3). The prevalence in rural areas was higher than in urban areas (p<0.01),resulting in an overall rural:urban OR of 2.6 (95%CI, 2.4–2.9). The rural:urban ORs and the 95% CI increasedcontinuously from 2.6, 2.3-3.0 to 2.7, 2.2-3.3, respectively, for 4 consecutive periods during the 22-yr study period.Moreover, the median age of onset among females was higher than that among males (p<0.01). For both sexesand in both areas, the prevalence rates declined and the median age of onset rose for 4 consecutive periods inthe 22-yrs time frame (p<0.01). Conculsions: These data reveal the epidemiological profile of ESCC in the areaof North China, and suggest that urban areas and rural people account for a growing proportion of the ESCCpatients although the prevalence of ESCC significantly declined and the median age-of-onset postponed overthe 22-yrs period. Moreover, the prevalence status of ESCC in rural areas also underlines the need for publichealth initiatives aimed at reducing risk factors of this fatal disease.