Epidemiology of Esophageal Cancer from the European Point of View

Abstract

Epidemiological data are usually presented in tables with masses of figures collected by experts who seem relatively uninterested in selling their data to a wider public. There are several reasons why surgeons should be interested in the epidemiology of cancer apart from the intellectual interest in the figures alone or their use in searching for aetiology and subsequently prevention of the disease. The main reason is proper assessment of treatment and comparison of the results of different therapies by “medical audit” or “peer review.” It is absolutely essential to have details about the original patient population treated because all surgical series have some bias of selection. Epidemiological data will give the overall incidence in a country but this must be standardised by reference to a standard population with regard to age and sex. Most centrally collected data unfortunately do not contain the other essential facts, which are histology and staging. Some of the Regional Centres in the UK do collect these details as well as those of treatment, but only from a minority of the total population. It therefore follows that the necessary information for medical audit, either of an individual surgeon or of a country, has to be gathered from several sources (Earlam et al. 1982; Earlam 1984). Many of the statements that follow will not be completely accurate because of the limitations of the original data, but they are presented as a framework which can improved as our knowledge increases.