The changing epidemiology of esophageal cancer in Finland and the impact of the surveillance of Barrett's esophagus in detecting esophageal adenocarcinoma

We examined the epidemiology of esophageal cancer in Finland and the role of the surveillance of Barrett's esophagus (BE) in detecting esophageal adenocarcinoma (EA) in our own hospital referral area. We observed that the incidence of EA in men has increased tenfold from the 1970s and was 1.10/100 000/year in 1998-2002. In women, a 4.5-fold increase was observed (incidence 0.11/100 000/year). In 1998-2002, the mean annual number of new EA cases was 57.4 (79.8% men) in Finland with a population of 5.2 million. In our hospital referral area with a mean population of 261 349, 11 EAs were observed in 1996-2001. Of them, two (18.2%) had BE. One EA was detected during surveillance. EA comprised 0.05% of all causes of deaths in our hospital referral area. We conclude that EA incidence has increased significantly in men in Finland, but still EA is seldom detected on BE surveillance. EA is an uncommon cause of death in our hospital referral area.