Present status of esophageal cancer and its treatment in Japan.

In 2001, 10,677 people died of esophageal cancer in Japan, 9,026 were men and 1,651 women–demonstrating a male-to-female ratio of 5.5. The number of esophageal cancer deaths have been increasing, correlated with the aging of Japan’s population. During the last two decades, the number of esophageal cancer deaths for men has increased by two-fold, and that for women 1.3-fold. The overall death rate in the general population from esophageal cancer in 2001 was 14.7 per 100,000 for men and 2.6 for women. This rate for Japanese men was double that for men in the USA or Western European countries, whilst that for Japanese women was similar to that for women in those countries. In western countries, the incidence of adenocarcinoma in Barrett’s esophagus has been increasing, and has become approximately equal to that of squamous cell carcinoma (SCC) among cases of esophageal cancer. According to the Comprehensive Registry of Esophageal Cancer in Japan published by the Japanese Society for Esophageal Diseases, the incidence of adenecarcinoma was 4.4% (32/734) in 1978, 1.2% (16/1,382) in 1988, and 1.6% (47/2,991) in 1998. Although these incidence rates in Japan might include cardia cancer or gastric cancer with esophageal invasion, there has been no tendency towards any increase in the incidence of adenocarcinoma in Japan. What kinds of treatment have been performed for Japanese patients with esophageal cancer? According to the Comprehensive Registry of Esophageal Cancer in Japan,5) among 2,953 patients registered during 1999, 1,817 (61.5%) underwent esophagectomy, 231 (7.8%) underwent endoscopic resection, 840 (28.4%) did not undergo surgery but received chemotherapy and/or radiotherapy, and the other 65 (2.2%) underwent palliative surgery such Present Status of Esophageal Cancer and its Treatment in Japan