Gastro-oesophageal junction cancers (ICD10 C15.2, C15.5, C16.0) 1

Transcription

1 Gastro-oesophageal junction cancers (ICD10 C15., C15.5, C16.0) 1 In England cancers of the gastro-oesophageal junction account for 0% of all cancers arising in the upper gastro-intestinal tract and are almost three times more common in men than in women (M to F ratio =.8:1). They occur in the lower third of the oesophagus and the cardia and the predominant morphology is adenocarcinoma. The risk factors for these cancers are not well understood but Barrett s oesophagus is a known risk factor and obesity and lack of fruit and vegetables in the diet are also thought to be risk factors. During the period 1998 to 00 a total of,71 people (,17 men and 8,59 women) were diagnosed with a gastro-oesophageal junction cancer in England. This gives age-standardised incidence rates per 100,000 European standard population () of 1.5 in men and.6 in women. The varies across the 8 cancer networks between 9.6 to 17. in men and. to. in women (Table 1; Figure 1). The cancer networks with a significantly lower incidence compared to the English average in both men and women are and North East London. The cancer network with a higher incidence for both men and women is (Figure ). Table 1: Age-standardised incidence rates per 100,000 European population by cancer network. Cancer network of residence Number Number , Arden , Derby/Burton , , Humber & Yorks Coast Lancs & S Cumbria Leics, Northants & Rutland , Mid Trent , , , England, , Please note the registry site is taken as the gold standard for site. However where this is C15.8 or C15.9 (overlapping sites or site unspecified) the morphology is used to subdivide into more specific sites. M805 to M808 = squamous cell carcinomas reassigned to C15. (Upper oesophagus). M81 to M88 and M8 to M89 = adenocarcinomas reassigned to C15.5 (Gastro-oesophageal junction). The residual C15.8 and C15.9 are then examined against their HES counterparts. Where the HES data has a more specific site this is used otherwise they are left as C15.8 and C15.9.

2 Figure 1: Age-standardised incidence rates per 100,000 European population by cancer network. Arden Humber & Yorks Coast Lancs & S Cumbria Leics, Northants & Rutland Mid Trent Figure : Funnel plot of age-standardised incidence rates for a) males and b) females by cancer network of residence, England, a) b)

3 Upper oesophagus cancers (ICD10 C15.0, C15.1, C15., C15.) In England cancers of the upper oesophagus account for approximately 1% of all cancers arising in the upper gastro-intestinal tract and are more common in women than in men (M to F ratio = 0.8:1). They occur in the upper two thirds of the oesophagus and the predominant morphology is squamous cell carcinoma. The risk factors for these cancers are known to be smoking and alcohol consumption which also have a synergistic effect. Poor diet is also a risk factor. These cancers are more common in people living in deprived areas. During the period 1998 to 00 a total of 11,00 people (,91 men and 6,099 women) were diagnosed with an upper oesophagus cancer in England. This gives age-standardised incidence rates per 100,000 European standard population () of.0 in men and.6 in women. The varies across the 8 cancer networks between 1.6 to.1 in men and.0 to.7 in women (Table 1; Figure 1). The cancer networks with a lower incidence compared to the English average are in the more affluent areas such as, and Surrey, West & Hampshire. Those with a higher incidence is seen in the less affluent areas such as, and (Figure ). Table 1: Age-standardised incidence rates per 100,000 European population by cancer network. Cancer network of residence Number Number Arden Derby/Burton Humber & Yorks Coast Lancs & S Cumbria Leics, Northants & Rutland Mid Trent England,91.0 6,099.6 Please note the registry site is taken as the gold standard for site. However where this is C15.8 or C15.9 (overlapping sites or site unspecified) the morphology is used to subdivide into more specific sites. M805 to M808 = squamous cell carcinomas reassigned to C15. (Upper oesophagus). M81 to M88 and M8 to M89 = adenocarcinomas reassigned to C15.5 (Gastro-oesophageal junction). The residual C15.8 and C15.9 are then examined against their HES counterparts. Where the HES data has a more specific site this is used otherwise they are left as C15.8 and C15.9.

4 Figure 1: Age-standardised incidence rates per 100,000 European population by cancer network. Arden Humber & Yorks Coast Lancs & S Cumbria Leics, Northants & Rutland Mid Trent Figure : Funnel plot of age-standardised incidence rates for a) males and b) females by cancer network of residence, England, a) 5 b)

5 Stomach (excl. cardia) cancers (ICD10 C16.1-C16.9) In England cancers of the stomach account for approximately % of all cancers arising in the upper gastro-intestinal tract and are more common in men than in women (M to F ratio = 1.5:1). They occur in any part of the stomach excluding the cardia and the predominant morphology is adenocarcinoma. The risk factors for these cancers are known to be Helicobacter pylori infection, smoking, poor diet, and excessive salt consumption. These cancers are more common in people living in deprived areas. During the period 1998 to 00 a total of,70 people (0,7 men and 1,67 women) were diagnosed with a stomach cancer in England. This gives age-standardised incidence rates per 100,000 European standard population () of 11.9 in men and 5. in women. The varies across the 8 cancer networks between 7.8 to 16.5 in men and.6 to 7.5 in women (Table 1; Figure 1). The cancer networks with a lower incidence compared to the English average are in the more affluent areas such as,, and. The cancer networks with higher incidence than the English average are, Yorkshire,. Interestingly, North East London, which is very deprived, has a similar high incidence to parts of Northern England (Figure ). Table 1: Age-standardised incidence rates per 100,000 European population by cancer network. Cancer network of residence Number Number Arden Derby/Burton , Humber & Yorks Coast Lancs & S Cumbria Leics, Northants & Rutland , Mid Trent , , , , , England 0, ,67 5. Please note the registry site is taken as the gold standard for site. However where this is C15.8 or C15.9 (overlapping sites or site unspecified) the morphology is used to subdivide into more specific sites. M805 to M808 = squamous cell carcinomas reassigned to C15. (Upper oesophagus). M81 to M88 and M8 to M89 = adenocarcinomas reassigned to C15.5 (Gastro-oesophageal junction). The residual C15.8 and C15.9 are then examined against their HES counterparts. Where the HES data has a more specific site this is used otherwise they are left as C15.8 and C15.9.

6 Figure 1: Age-standardised incidence rates per 100,000 European population by cancer network. Arden Humber & Yorks Coast Lancs & S Cumbria Leics, Northants & Rutland Mid Trent Figure : Funnel plot of age-standardised incidence rates for a) males and b) females by cancer network of residence, England, a) b)

7 Oesophagus not known cancers (ICD10 C15.8, C15.9) In England cancers of an unspecified site within the oesophagus account for approximately 5% of all cancers arising in the upper gastro-intestinal tract and are marginally more common in men than in women (M to F ratio = 1.1:1). These cancers have not been assigned to a specific area of the oesophagus and usually have an unspecified morphology. The risk factors for these cancers are most likely to be smoking, alcohol consumption, and poor diet. During the period 1998 to 00 a total of,16 people (,1 men and 1,99 women) were diagnosed with an oesophagus not known cancer in England. This gives age-standardised incidence rates per 100,000 European standard population () of 1. in men and 0.7 in women. The varies across the 8 cancer networks between 0. to. in men and 0. to 1. in women (Table 1; Figure 1). Cancer networks with a significantly higher incidence than the English average are,, and in men, and South East London and in women. The cancer network with a significantly lower incidence than the English average in both men and women is. Table 1: Age-standardised incidence rates per 100,000 European population by cancer network. Cancer network of residence Number Number Arden Derby/Burton Humber & Yorks Coast Lancs & S Cumbria Leics, Northants & Rutland Mid Trent England,1 1. 1, Please note the registry site is taken as the gold standard for site. However where this is C15.8 or C15.9 (overlapping sites or site unspecified) the morphology is used to subdivide into more specific sites. M805 to M808 = squamous cell carcinomas reassigned to C15. (Upper oesophagus). M81 to M88 and M8 to M89 = adenocarcinomas reassigned to C15.5 (Gastro-oesophageal junction). The residual C15.8 and C15.9 are then examined against their HES counterparts. Where the HES data has a more specific site this is used otherwise they are left as C15.8 and C15.9.

8 Figure 1: Age-standardised incidence rates per 100,000 European population by cancer network. Arden Humber & Yorks Coast Lancs & S Cumbria Leics, Northants & Rutland Mid Trent Figure : Funnel plot of age-standardised incidence rates for a) males and b) females by cancer network of residence, England, a) b)