食管癌（EC）是全球第7多见的癌症，在美国排名第14位。需要更多数据来研究其2个主要组织学亚型——食管鳞状细胞癌（SCE）和食管腺癌（ACE）的发病率变化模式。为了研究1975年到2018年期间食管癌、ACE和SCE的发病率变化趋势，本人采用了基于人群的横断面研究设计，数据来自1975年1月至2018年12月的9个监测、流行病学和结果（SEER）登记处的数据，以及2000年1月至2018年12月的全部21个登记处对1975年至2018年期间被诊断为食管癌的患者进行分析（按照国际疾病分类第三版代码）。计算了食管癌、ACE和SCE的年龄标准化发病率（AAIRs），使用拐点回归分析确定发病率的年百分比变化（APC）的时机和幅度。数据分析始于2021年，在2023年更新和完成。按照组织学、解剖学位置、分期、性别、年龄、种族和族裔以及地理区域进行分层的食管癌年龄标准化发病率（AAIRs）的APC。分析保留了47,648例被诊断为食管癌的患者。其中22,419例（47.1%）为SCE诊断，22,217例（46.6%）为ACE诊断，3012例（6.3%）为其他亚型。EC的AAIR从1975年的每10万人口4.14下降到2018年的4.18，SCE的AAIR从1975年的3.06下降至2018年的1.15，ACE的AAIR也有类似下降趋势，从1975年的0.42上升至2018年的2.78。从1975年到2004年，食管癌的发病率显著增加（APC，0.53；95% CI，0.4至0.7），但从2004年至2018年，发病率显著下降（APC，-1.03；95% CI，-1.3至-0.7）。SCE的发病率显著持续下降（APC，-2.80；95% CI，-3.0至-2.6），而ACE在2000年至2006年间上升（APC，2.51；95% CI，1.0至4.0），但自2006年至2018年稳定。这个横断面研究的结果表明，自2004年以来EC的发病率略有下降，SCE的发病率持续下降，而ACE的发病率则稳定了十多年。了解与ACE发病率稳定有关的因素，可能有助于制定公共卫生干预措施。

Esophageal cancer (EC) is the 7th most common cancer worldwide and 14th in the US. More data are needed to study the changing incidence patterns of its 2 primary histologic subtypes, squamous cell carcinoma of the esophagus (SCE) and adenocarcinoma of the esophagus (ACE).To examine temporal trends in incidence rates of EC, ACE, and SCE from 1975 through 2018.In this population-based cross-sectional study, data were derived from 9 Surveillance, Epidemiology, and End Results (SEER) registries from January 1975 through December 2018 and from all 21 registries for January 2000 through December 2018 for patients with a diagnosis of EC from 1975 through 2018 (International Classification of Disease-Oncology, Third Edition codes). Age-adjusted incidence rates (AAIRs) of EC, ACE, and SCE were calculated. The timing and magnitude of the annual percentage change (APC) in incidence were examined using Joinpoint regression analyses. Data analysis was started in 2021 and updated and completed in 2023.The APC for age-adjusted EC incidence rates as stratified by histology, anatomical location, stage, sex, age, race and ethnicity, and geographic region.A total of 47 648 patients with a diagnosis of EC were retained for analysis. These included 22 419 (47.1%) with a diagnosis of SCE, 22 217 (46.6%) with ACE, and 3012 (6.3%) with other subtypes. The AAIR for EC changed from 4.14 per 100 000 population in 1975 to 4.18 in 2018, AAIRs of SCE declined from 3.06 in 1975 to 1.15 in 2018 as well as for ACE, and AAIRs increased from 0.42 in 1975 to 2.78 in 2018. From 1975 through 2004, EC incidence significantly increased (APC, 0.53; 95% CI, 0.4 to 0.7) but significantly decreased (APC, -1.03; 95% CI, -1.3 to -0.7) from then until 2018. The APC of SCE significantly continued to decline (-2.80, 95% CI, -3.0 to -2.6), and ACE increased from 2000 to 2006 (APC, 2.51; 95% CI, 1.0 to 4.0) but has since stabilized from 2006 to 2018.The results of this cross-sectional study suggest that the incidence of EC modestly declined since 2004 and that the incidence of SCE continued to decline while the incidence rate of ACE plateaued for more than a decade. Understanding factors associated with plateaued rates of ACE may help inform public health interventions.