Esophageal and Gastric Cancer Incidence and Mortality Trends in Norway, 1993-2022: A Registry-Based Study.

Introduction: Esophageal and gastric cancers account for nearly 1.5 million new cases and 1.1 million deaths annually worldwide. In western countries, the incidence of esophageal cancer is rising while that of gastric cancer has decreased, although the pattern varies between the morphological types and subsites. We aim to describe the burden of esophageal and gastric cancers in Norway by providing national trends in incidence and mortality, separately for esophageal squamous cell carcinoma (SCC) and adenocarcinoma (AC), and for gastric ACs by gastric subsites. Methods: We extracted information about all esophageal (ICD10 C15) and gastric cancer (ICD10 C16) patients diagnosed 1993‒2022 from the Cancer Registry of Norway. Age-standardized (European standard population) rates and performed joinpoint regression analyses were calculated to examine trends in incidence and mortality over time, for esophageal cancer SCC and AC and by subsite for gastric AC (cardia: ICD10 C16.0 and non-cardia: ICD10 C16.1-9). We used annual percent change (APC) and weighted average APC (AAPC), stratified by sex, age group, and stage at diagnosis. Results: During 1993-2022, 6,433 esophageal cancers (2,616 SCC, 3,817 AC) and 14,453 gastric AC were diagnosed, and 4,683 esophageal and 10,421 gastric AC deaths occurred. The incidence and mortality of esophageal ACs increased whereas the rates for esophageal SCC declined in men and were stable in women. The highest AC incidence and mortality increases were seen in men (incidence AAPC = 2.8) and ages ≥70 years (incidence AAPC = 5.9). In contrast, the incidence and mortality of gastric cancer decreased over time, most pronounced for non-cardia gastric AC (incidence AAPC men =-5.3, women =-3.9). Conclusion: The incidence and mortality of esophageal AC has increased in Norway during the last decades, most pronounced in men, ages ≥70 years. The rates of SCCs decreased, although trends differed between sex and age groups. The incidence and mortality of gastric AC decreased in all age-groups for both sexes, especially for non-cardia gastric cancer.