Cancer
Age-period-cohort modeling of esophageal carcinoma risk in a middle eastern country:1980–2019 Saeed Akhtar* Saeed Akhtar Ahmad Al-Shammari Mohammad Al-Huraiti Fouzan Al-Anjery
Background: Esophageal cancer is the eighth most common cancer and the sixth leading cause of cancer-related deaths worldwide. Owing to disparity in epidemiology of esophageal cancer across different populations, monitoring the esophageal cancer trends is crucial. Therefore, this cross-sectional cohort study examined the contributions of age, period, and cohort effects in the temporal trends of esophageal cancer in Kuwait.
Methods: The data on incident esophageal carcinoma cases from January 1980 through December 2019, from Kuwait Cancer Control Center Registry and reference population were obtained. Age-period-cohort (APC) analysis was conducted using a loglinear Poisson regression model. Descriptive statistics were complemented with APC parameters’ estimates. Age effect was presented as IRs (per 105 person-years), whereas period and cohort effects as adjusted RRs.
Results: Over the study period, a total of 496 esophageal carcinoma cases in 12.8 million person-years at risk were diagnosed. Of these, 269 (54.23%) were esophageal squamous-cell carcinoma, 147 (29.64%) adenocarcinoma and 80 (16.13%) cases were histopathological unspecified. Subsequently, all histopathological types were grouped as esophageal cancer. Overall age-standardized incidence rate (per 105 person-years) of esophageal cancer during study period was 10.51 (95% CI: 6.62-14.41). APC analysis showed that age and birth cohort effects were significant (p < 0.05) determinants of declining, and subsequently stabilizing esophageal carcinoma incidence rates in all three temporal dimensions (Figure1).
Conclusions: A substantial decline in esophageal carcinoma incidence rates was recorded, which significantly varied in all three temporal dimensions. The observed birth cohort patterns suggest changing lifestyle and dietary patterns seem to be responsible for decreasing esophageal cancer risk in Kuwait. Future studies may examine the biological basis for temporal decline in esophageal cancer risk.
