Time trends and pathological profile of carcinoma lower oesophagus and gastro-oesophageal junction over the last 20 years--an experience from South India.

There is an upward trend in the incidence of adenocarcinoma lower oesophagus in western countries. However there is only limited comparable data from Asian countries. We conducted a retrospective analysis of our data compiled over a twenty-year period (1985-2004). All lesions diagnosed as either squamous cell carcinoma or adenocarcinoma involving the oesophagus with or without involvement of the gastro-oesophageal junction were included in the study. 476 cases with biopsy proven malignancy (either adeno or squamous) of lower oesophagus were studied. The pattern of change in frequency and histology over twenty years was analysed using the chi square test for trend. There was a consistent increase in the frequency of cancer involving the gastro-oesophageal junction though it did not reach statistical significance (p = 0.15). Out of 476 lower oesophageal cancers, 249 were adeno-carcinomas and 227 were squamous cell carcinomas. Adenocarcinoma involving the gastro-oesophageal junction showed consistent increase even though the p value was not significant (p = 0.09) and this therefore requires further longitudinal studies. There was no change in trend for pattern and frequency of squamous cell carcinoma oesophagus involving different sub-sites during the study period.