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Gastrointestinal Adenocarcinoma Incidence and Survival Trends in South Australia, 1990–2017

College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
Flinders Medical Center, Division of Surgery and Perioperative Medicine, Flinders University, Adelaide, SA 5042, Australia
Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5042, Australia
Department of Medical Oncology, Flinders Medical Centre, Flinders University, Adelaide, SA 5042, Australia
Cedars-Sinai Medical Center, Division of Digestive and Liver Diseases, Los Angeles, CA 90048, USA
Authors to whom correspondence should be addressed.
Academic Editors: Irit Ben Aharon and David Wong
Cancers 2022, 14(2), 275;
Received: 2 December 2021 / Revised: 27 December 2021 / Accepted: 5 January 2022 / Published: 6 January 2022
(This article belongs to the Special Issue Young-Onset GI Cancer)
This study from South Australia using the state’s Cancer Registry data provides compelling evidence for a significant increase in the incidence of young-onset (18–50 years) gastrointestinal (oesophageal, stomach, colon and rectum, and pancreas) adenocarcinomas over the last three decades. The trend observed in the young cohort was not mirrored in older individuals >50 years. This increased incidence, though noted in both sexes, was more pronounced in males compared to females. Survival in the young-onset adenocarcinoma cohort was only seen in patients with colorectal cancers, but not oesophagus, stomach and pancreas. This study calls for a concerted effort aimed at determining the sociodemographic factors underlying this disturbing trend with the aim of developing preventative strategies.
Background & Aims: Globally, there has been a concerning rise in the incidence of young-onset cancers. The aim of this study was to provide trends in the incidence and survival of gastrointestinal adenocarcinomas (oesophagus, stomach, pancreas, and colorectal) in South Australia over a 27-year period. Methods: This is a cross-sectional analysis of a prospective longitudinal database including all cases of gastrointestinal adenocarcinomas prospectively reported to the South Australian (State) Cancer Registry from 1990 to 2017. Results: A total of 28,566 patients diagnosed with oesophageal, stomach, pancreatic, or colorectal adenocarcinoma between 1990 and 2017 were included in the study. While the overall incidence for gastrointestinal adenocarcinomas in individuals >50 years has decreased since 2000 (IRR of 0.97 (95% CI 0.94–1.00; p = 0.06)) compared to 1990–1999, the rate amongst individuals aged 18–50 has significantly increased (IRR 1.41 (95% CI 1.27–1.57; p < 0.001)) during the same reference time period. Although noted in both sexes, the rate of increase in incidence was significantly greater in males (11.5 to 19.7/100,000; p < 0.001). The overall survival from adenocarcinomas across all subsites improved in the >50-year cohort in the last decade (HR 0.89 (95% CI 0.86–0.93; p < 0.001)) compared to 1990–1999. In individuals aged 18–50 years, there has only been a significant improvement in survival for colorectal cancer (HR 0.82 (95% CI 0.68–0.99; p < 0.04)), but not the other subsites. A lower overall survival was noted for males in both age cohorts (18–50 years—HR 1.24 (95% CI 1.09–1.13; p < 0.01) and >50 years—HR 1.13 (95% CI 1.10–1.16; p < 0.001), respectively) compared to females. Conclusions: This study from South Australia demonstrates a significant increase in young-onset gastrointestinal adenocarcinomas over the last 28 years, with a greater increase in the male sex. The only significant improvement in survival in this cohort has been noted in colorectal cancer patients. View Full-Text
Keywords: outcomes; morbidity; mortality; stomach; pancreas; colon outcomes; morbidity; mortality; stomach; pancreas; colon
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MDPI and ACS Style

Schell, D.; Ullah, S.; Brooke-Smith, M.E.; Hollington, P.; Yeow, M.; Karapetis, C.S.; Watson, D.I.; Pandol, S.J.; Roberts, C.T.; Barreto, S.G. Gastrointestinal Adenocarcinoma Incidence and Survival Trends in South Australia, 1990–2017. Cancers 2022, 14, 275.

AMA Style

Schell D, Ullah S, Brooke-Smith ME, Hollington P, Yeow M, Karapetis CS, Watson DI, Pandol SJ, Roberts CT, Barreto SG. Gastrointestinal Adenocarcinoma Incidence and Survival Trends in South Australia, 1990–2017. Cancers. 2022; 14(2):275.

Chicago/Turabian Style

Schell, Dominique, Shahid Ullah, Mark E. Brooke-Smith, Paul Hollington, Marina Yeow, Christos S. Karapetis, David I. Watson, Stephen J. Pandol, Claire T. Roberts, and Savio G. Barreto. 2022. "Gastrointestinal Adenocarcinoma Incidence and Survival Trends in South Australia, 1990–2017" Cancers 14, no. 2: 275.

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