Geographical disparities and temporal trends in the prevalence of hospitalized esophageal carcinoma patients in the United States.

Abstract

e16161 Background: Esophageal cancer (EC) is a highly aggressive malignancy that remains a major cause of cancer-related morbidity and mortality worldwide. In the U.S., EC is currently the seventh most common cause of cancer-related deaths, with an estimated 20,640 new cases and 16,410 deaths in 2023 alone, according to the American Cancer Society. In the United States, the incidence of EC has shown notable geographic disparities, with the highest prevalence observed in the Southern and Mid-western regions of the country. However, Geographical disparities and trends in the prevalence of hospitalized patients diagnosed with esophageal cancer have not been extensively investigated. Methods: A retrospective analysis was conducted using the National Inpatient Sample (NIS) database from 2016 to 2021 to identify patients with a diagnosis of EC in hospitals. Main outcome was to access the regional disparities in trend and prevalence of EC in the US. Results: A total of 240,570 cases of EC were analyzed from 2016 to 2021. There was a statistically significant upward trend in prevalence of EC in the southern US (p trend < 0.001) and midwestern US (p trend = 0.002), while there was a statistically significant downward trend in prevalence of EC in Northeast US (p trend = 0.013). Moreover, there were regional variations in prevalence of EC; Southern region had the highest prevalence of EC at 36.37% ,compared to Midwest region 24.09%; This was more than the prevalence in the West and Northeast, 18.05% and 20.64%% respectively, (p < 0.001). Conclusions: Rising prevalence of EC in the southern US is likely due to regional systemic health care access issues and limited health care literacy especially in rural areas. Other factors include increased prevalence of adverse risk factors such as smoking, alcohol consumption, dietary habits, obesity and gastroesophageal reflux disease. These findings emphasize the urgent need for targeted public health strategies aimed at proportional distribution of health care resources and optimizing compliance with Barrett’s screening in patients with obvious risk factors to maximize early detection and prevention of EC. Geographical disparities and trends in prevalence of hospitalized esophageal cancer patients. Year 2016 2017 2018 2019 2020 2021 P trend value Total ECA 38445 39280 40110 42485 39415 40835 <0.001 Hospital region, %  Northeast (%) 21.12 20.76 19.78 21.25 20.6 20.34 0.013  Midwest (%) 24.72 24.77 25.12 25.46 24.55 24.76 0.002  South (%) 35.75 35.76 36.05 35.52 37.57 37.64 <0.001  West (%) 18.4 18.71 19.05 17.77 17.28 17.26 0.723