Trends in the subsite and morphology of oesophageal and gastric cancer in England and Wales 1971-1998

Background: The incidence of adenocarcinoma of the oesophagus and gastric cardia has increased in many countries. Aim: To describe the trends in the subsite and morphology of oesophageal and gastric cancer using cancer registry data from 1971 to 1998. Methods: We calculated the overall age-standardised incidence in each year; the age-standardised incidence by subsite, by morphology and by subsite and morphology; and the ratio of the rates in men and women in 1971 and 1998. Results: The incidence of oesophageal adenocarcinoma increased from 1.5 to 7.0 per 100 000 men and from 0.4 to 1.5 per 100 000 women. The incidence of cancer at the cardia also increased, from 2.0 to 5.4 per 100 000 men and from 0.6 to 1.4 per 100 000 women, but the incidence of gastric cancer without a specified subsite decreased markedly from 21.3 to 9.3 per 100 000 men and from 10.7 to 4.2 per 100 000 women. Conclusions: Although some of the increase in the incidence of adenocarcinoma of the gastric cardia is probably real, this interpretation is limited by the proportion of cancers without specified subsites or morphologies.