Background: Major changes in the incidence of oesophageal and gastric cancers have been reported\r\ninternationally. This study describes recent trends in incidence and survival of subgroups of oesophageal and\r\ngastric cancer in England between 1998 and 2007 and considers the implications for cancer services and policy.\r\nMethods: Data on 133,804 English patients diagnosed with oesophageal and gastric cancer between 1998 and\r\n2007 were extracted from the National Cancer Data Repository. Using information on anatomical site and tumour\r\nmorphology, data were divided into six groups; upper and middle oesophagus, lower oesophagus, oesophagus\r\nwith an unspecified anatomical site, cardia, non-cardia stomach, and stomach with an unspecified anatomical site.\r\nAge-standardised incidence rates (per 100,000 European standard population) were calculated for each group by\r\nyear of diagnosis and by socioeconomic deprivation. Survival was estimated using the Kaplan-Meier method.\r\nResults: The majority of oesophageal cancers were in the lower third of the oesophagus (58%). Stomach with an\r\nunspecified anatomical site was the largest gastric cancer group (53%). The incidence of lower oesophageal cancer\r\nincreased between 1998 and 2002 and remained stable thereafter. The incidence of cancer of the cardia, noncardia\r\nstomach, and stomach with an unspecified anatomical site declined over the 10 year period. Both lower\r\noesophageal and cardia cancers had a much higher incidence in males compared with females (M:F 4:1). The\r\nincidence was also higher in the most deprived quintiles for all six cancer groups. Survival was poor in all subgroups\r\nwith 1 year survival ranging from 14.8-40.8% and 5 year survival ranging from 3.7-15.6%.\r\nConclusions: An increased focus on prevention and early diagnosis, especially in deprived areas and in males, is\r\nrequired to improve outcomes for these cancers. Improved recording of tumour site, stage and morphology and\r\nthe evaluation of focused early diagnosis programmes are also needed. The poor long-term survival reinforces the\r\nneed for early detection and multidisciplinary care.
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