RECENT TRENDS OF GASTROESOPHAGEAL REFLUX DISEASE AND ESOPHAGEAL ADENOCARCINOMA IN JAPAN

Abstract

In Western countries, the incidence of esophageal adenocarcinoma began to increase in the 1960s to 1970s, and sharply increased in the 1980s to 2000s. In Japan, a series of recent reports indicated that the incidence of esophageal adenocarcinoma began to increase in the 2000s to 2010s, 40 to 50 years behind the situation in Western countries. The time lag in the onset of esophageal adenocarcinoma between Western countries and Japan may be related to the difference in the time when the Helicobacter pylori (H. pylori) infection rate began to decline. Whether or not a rapid increase in esophageal adenocarcinoma cases that occurred in Western countries can also occur in Japan in the future is of great concern. At present, such a rapid increase in esophageal adenocarcinoma cases is unlikely to occur in Japan due to the lower risk of conditions predisposing to gastroesophageal reflux disease (GERD) such as higher gastric acid secretion level and obesity rate in Japanese, and due to ethnic differences in susceptibility to esophageal adenocarcinoma. However, the incidence of esophageal adenocarcinoma in Japan is expected to gradually increase due to the further decrease in the H. pylori infection rate.