Esophageal Adenocarcinoma Increasingly Found in Adults Under 50

A study finds that younger patients are also more likely to be diagnosed at advanced stages of the disease, a type of esophageal cancer.

Esophageal adenocarcinoma (EAC)—a type of cancer of the esophagus—is becoming more prevalent among adults under the age of 50, and these younger adults are more likely to be diagnosed at advanced stages of cancer,  according to a study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research. 

While more than 18,000 cases of esophageal cancer are diagnosed in the United States every year, it makes up only about 1 percent of U.S. cancer diagnoses. However, the five-year survival rate is poor, at only about 20 percent. 

“Physicians must keep in mind that EAC is not a disease of the elderly, and that outcomes for young people with EAC are dismal,” said the study’s lead author, Don C. Codipilly, MD, a gastroenterology fellow at the Mayo Clinic in Rochester, Minnesota.

Using a massive database of cancer cases, Iyer and his colleagues determined that incidence of EAC in patients under age 50 increased an average of 2.9 percent per year between 1975 and 2015.

Almost 85 percent of those under 50 diagnosed with EAC had disease at the regional or distant stages, when it is much harder to treat than local disease, compared with 67.3 percent of those who were 50 years of age or older. 

“The magnitude of late-stage disease and poor cancer-related survival in this age group were surprising findings for us,” said the study’s corresponding author, Prasad G. Iyer, MD, MSc, professor of medicine in the Barrett’s Esophagus Unit of the Division of Gastroenterology and Hepatology at the Mayo Clinic. “As such, it is important to understand the epidemiology of esophageal cancer to target our screening strategies.”

The authors pointed out that the rising incidence of EAC in younger adults mirrors the trend in colon cancer. In both cases, physicians may attribute symptoms to other causes, delaying diagnosis and potentially leading to worse outcomes, Codipilly said.