Is the age of diagnosis of esophageal adenocarcinoma getting younger? Analysis at a tertiary care center

There are emerging data that patients 50 years are diagnosed with esophageal adenocarcinoma (EAC) more frequently, suggesting that the age threshold for screening should be revisited. This study aimed to determine the age distribution, outcomes, and clinical features of EAC over time. The pathology database at the Hospital of the University of Pennsylvania was reviewed from 1991 to 2018. The electronic health records and pathology were reviewed for age of diagnosis, pathology grade, race, and gender for a cohort of 630 patients with biopsy proven EAC. For the patients diagnosed from 2009 to 2018, the Penn Abramson Cancer Center Registry was reviewed for survival and TNM stage. Of the 630 patients, 10.3% (65 patients) were 50 years old [median 43 years, range 16 49]. There was no increase in the number of patients 50 years diagnosed with EAC (R=0.133, P=0.05). Characteristics of those 50 years versus 50 years showed no difference in tumor grade. Among the 179 eligible patients in the cancer registry, there was no significant difference in clinical or pathological stage for patients 50 years (P value=0.18). There was no association between diagnosis age and survival (P=0.24). A substantial subset of patients with EAC is diagnosed at 50 years. There was no increasing trend of EAC in younger cohorts from 1991 to 2018.We could not identify more advanced stage tumors in the younger cohort. There was no significant association between diagnosis age and survival.