A systemic trend analysis of young onset esophageal cancer in American population, 2012-2021.

Abstract

e16098 Background: Esophageal adenocarcinoma (EAC) is a rapidly growing cancer in the United States. Although often associated with older populations, there is interest in understanding incidence trends across all age groups, particularly younger individuals (< 49 years). This study evaluates both the incidence of EAC and stage distribution across age groups to inform targeted screening and prevention strategies. Methods: This retrospective cohort study utilized data from the National Cancer Database (NCDB) from 2012 to 2021. Annual incidence rates were analyzed across three age groups (< 49, 50–69, and 70–90 years) and visualized with linear trend lines. Stage distribution at diagnosis (Stages 0–IV) was also compared among these age groups to identify differences in disease presentation. Results: Incidence trends revealed significant differences among age groups. Linear regression analysis showed a slight decline in incidence for the < 49 age group (slope = -0.0016) over the 10-year period, with rates remaining low and stable. In contrast, the 50–69 and 70–90 age groups demonstrated similar upward trends (slope = 0.0527) reflecting a moderate and consistent increase in incidence over time. The 50–69 age group had the highest overall incidence rates, increasing from approximately 2.0 to 2.5 per 100,000 between 2012 and 2021. Stage distribution analysis revealed that younger patients (< 49 years) were more likely to present with advanced-stage disease, with 47.08% diagnosed at Stage IV compared to 38.99% in the 50–69 group and 34.26% in the 70–90 group. Early-stage diagnoses (Stages 0/I) were most common in the 70–90 age group (20.05%) and least common in the < 49 group (13.42%). Conclusions: The incidence of EAC is increasing in middle-aged (50–69) and older (70–90) populations, while younger individuals (< 49) maintain stable but low rates of disease. However, the younger group is disproportionately diagnosed at advanced stages, highlighting a need for greater awareness and potential early detection efforts in high-risk young individuals. Meanwhile, middle-aged and older populations should remain the primary focus of prevention and screening programs to address the rising burden of EAC in these age groups.