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Cancer of the esophagus and stomach

857 people were diagnosed with esophageal cancer or stomach cancer in 2022. The diseases are more common for men than for women.

Cancer of the oesophagus and stomach is more common worldwide than in Norway, but most patients are diagnosed with the disease late in the course of the disease. The prevalence of the disease at the time of diagnosis has an impact on survival, which means that only a quarter of patients are alive after 5 years. At the same time, an increase in survival is seen in patients with cancer of the esophagus.

Detection of the connection between stomach cancer and the bacterium Helicobacter pylori, which is also an important cause of stomach ulcers, has led to new preventive treatment, and stomach cancer has gone from being a relatively common cancer to becoming a disease that now affects relatively few. 

Risk factors

Working in a forward bent position increases the risk of reflux of stomach acid up into the oesophagus, which can lead to inflammation of the oesophagus. This in turn can lead to the condition Barret's oesophagus, which slightly increases the risk of cancer. This occurs in about 1-5 percent for people with Barret's esophagus. 

Etching damage by lye, which leads to scarring, can increase the risk of esophageal cancer decades after the injury.

Chronic infection of the stomach due to Helicobacter Pylori may increase the risk of stomach cancer. The infection can be treated with antibiotics and the risk is reduced.

Previous operations to remove parts of the stomach and radiation therapy in the abdominal region from previous cancer treatment may also increase the risk of stomach cancer.

In very rare cases, stomach cancer is hereditary. Those with close  family members with stomach cancer are at increased risk, but it's not clear whether it's due to genes or similar lifestyles.

Source: helsenorge.no

Read about preventing all cancers on kreftregisteret.no

New cases

A total of 572 men and 285 women contracted esophageal or gastric cancer in 2022. The number of cases per 100,000 is about 9 for men and 4 for women.

Aging

The median age (both sexes) for esophageal cancer is 71 years and for stomach cancer 73 years. This means that half of all those who receive these diagnoses are over 71 years and 73 years respectively. 

Survival

Five-year relative survival for esophageal cancer in the period 2018-2022 is about 22 percent for men and 31 percent for women. For stomach cancer, survival is about 30 percent for men and 33 percent for women. The survival rate for patients with distant metastasis is significantly lower.

The figure shows survival for oesophageal cancer by age group for both sexes. From figure 8.1-C in Cancer in Norway 2022.

In the last 15 years, we have seen almost a doubling in survival for men and a threefold increase in survival for women. Younger people have better survival rates than older people.

The figure shows survival for gastric cancer by age group for both sexes. From figure 8.1-D in Cancer in Norway 2022.

There is little gain in 5-year relative survival over the past 15 years. This applies to both sexes and all age groups.

Survivors with cancer of the esophagus and stomach

At the end of 2022, there were 1050 people in Norway who either have or have had esophageal cancer, and 2194 people who have or have had stomach cancer. 

Number of deaths

In 2021, 202 men and 60 women died of esophageal cancer, while 154 men and 113 women died of stomach cancer. 

Development over time

The figure shows trends for men in incidence (dark blue), mortality (light blue) and 5-year relative survival (green) for esophageal cancer in the period 1965-2022. From figure 9.1-C in Cancer in Norway 2022

The figure shows trends for women in incidence (red), mortality (pink) and 5-year relative survival (brown) for esophageal cancer in the period 1965-2022. From Figure 9.1-C in Cancer in Norway 2022.

The disease is more common in men than in women. The incidence of oesophageal cancer has remained relatively stable for both sexes over the last 10-year period, while survival from oesophageal cancer has  increased for both sexes. 

Cancer of the stomach is a relatively rare cancer in Norway, and the incidence has been declining for many years. Some reasons why fewer people get stomach cancer are increasing use of refrigerated and frozen foods and less use of smoked and pickled foods.

Quality registry for cancer of the oesophagus and stomach

The quality register does not currently have national status. The work to develop a national quality registry for cancer of the oesophagus and stomach started in November 2008. The Cancer Registry of Norway and NGICG-ØV (the Norwegian Gastrointestinal Cancer Group's advisory board for cancer of the oesophagus and stomach) collaborate on the quality registry.

The Cancer Registry of Norway is responsible for data processing and works together with the professional community to develop the registry. 

The Quality Registry collects data on the assessment and treatment of this patient group. The purpose of the registry is to improve the quality of the health care provided to patients with cancer of the oesophagus and stomach.  The registry shall also provide a basis for research that can provide new knowledge about causes, diagnosis and disease course and treatment effects.
 
The register has not yet published figures for 2021 and 2022.
 
Proportion of patients with gastric cancer diagnosed in 2020 who underwent surgery, by catchment area. From Fig. 3.32 of the annual report.
 
The figure shows that there is variation between the catchment areas of the health enterprises
with regard to the proportion of patients with gastric cancer who
is undergoing surgery.
 
In 2020, there was a marked decline in the proportion of patients who underwent surgery in the South-Eastern Norway Regional Health Authority. The Professional Council in the quality register has contacted Oslo University Hospital regarding the results. The reason for the decline may be the patients' disease burden or that fewer are referred for assessment for surgery.
 
Quality targets given by the professional council are set at between 35 per cent and 45 per cent (marked in green in the figure). The medical council will follow future trends in the proportion of surgeries to ensure equal provision regardless of where in the country the patients are resident.

Steps you can take to reduce your risk of getting cancer of the esophagus and stomach

Ensure a healthy diet with plenty of vegetables and fruits, especially with vitamins A and C. Dairy products are beneficial. Avoid a lot of red meat and processed meat.

Limit the amount of smoked foods and salt. Smoked foods may contain nitrite and bitrate, which can be converted into unfavorable compounds in the stomach by the bacterium Helicobacter Pylori.

Avoid smoking, limit alcohol intake and keep a healthy body weight.

For esophageal cancer, the HPV vaccine is additionally recommended, as it reduces the risk of being infected with HPV (Human Papillomavirus). This infection of the esophagus can increase the risk of a rare form of squamous cell carcinoma.

Source: helsenorge.no

Questions about cancer

The Cancer Registry of Norway is a research institution. Our professionals therefore do not answer questions about diagnosis, assessment, treatment and follow-up from patients or their relatives.

Questions about this should be directed to your own GP, treating institution or the Cancer Society Advisory Service tel: 21 49 49 21

Useful Links

National action programme with guidelines for diagnosis, treatment and follow-up of esophageal cancer

National action programme with guidelines for diagnosis, treatment and follow-up of gastric cancer

Read about esophageal cancer on kreftforeningen.no

Read about stomach cancer on kreftforeningen.no

Esophageal Cancer on National Cancer Institute website

Stomach (Gastric) Cancer on National Cancer Institute website