Changing pattern of oesophageal cancer in a general hospital in the UK

Reports in the literature indicate that there is a change in the pattern of oesophageal cancer. This prompted us to retrospectively examine 15 years of endoscopy records in this district general hospital to identify all patients with oesophageal cancer and to determine whether data from our area were similar to other reported series. Examination of 22,789 consecutive endoscopy records identified 199 oesophageal cancer cases. Overall 50% of these were adenocarcinomas, an even higher percentage than that reported in series based on cancer registry information. The number of squamous cell carcinomas in females was noted to be rising and this was associated with an increase in the age of female patients. Female patients were also significantly older than males. The cancer origins tended to be lower in the oesophagus in males than in females. These results support a rise in the percentage of oesophageal adenocarcinomas. Absolute numbers of cancers detected rose over the 15-year study, but this was in direct proportion to the number of endoscopies carried out annually and probably reflects an increased usage of endoscopy services during the period of study.