Re: Incidence of Adenocarcinoma of the Esophagus Among White Americans by Sex, Stage, and Age

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We read the excellent study by Brown et al. ( 1 ) in your great Journal. This study provides consistent evidence that the incidence of adenocarcinoma of the esophagus has been increasing substantially in the Western world for the past 20 years ( 1 , 2 ). We would like to provide some complementary data from the point of view of the Far East that indicate that this trend may not be universal.

Shibata et al. ( 3 ), in their population-based study, reported no dramatic increase in the incidence of adenocarcinoma of the esophagus in Japan from 1993 to 2001. Similar results have also been reported in Hong Kong ( 4 ) and Korea ( 5 ). Using methodology similar to that of Shibata et al. ( 3 ) and up-to-date data from the Cancer Registry of Taiwan, we found a similar trend in Taiwan. The age-standardized incidence rate for adenocarcinoma of the esophagus in Taiwan remained relatively stable from 1996 to 2005 among both men and women, with the Taiwan population in year 2005 as the reference population. The proportion of adenocarcinoma among all patients with esophageal cancer was also persistently low in these regions ( Table 1 ).