Methods: Using data extracted from the New South Wales Cancer Registry, computing age standardised rates of incidence (ASIR), stage, survival and mortality for oesophageal squamous cell carcinoma (OSCC), gastro-oesophageal adenocarcinoma (OAC), and gastric carcinoma (GC) in NSW 1992-2022.
Results: Trends varied by site and histology. Between 1992-2022, ASIR for OAC increased 4.0 to 5.9 /100,000 (males 7.2 to 9.9, females 1.5 to 2.0/100,000); OSCC and GC incidence declined: OSCC 4.0 to 2.0/100000 (males 4.5 to 2.0; females 3.5 to 2.0/100,000); GC 10.1 to 4.3/100000 (males 14.4 to 5.1, females 6.6 to 3.4/100,000). Trends in incidence rose faster in males for OAC, declining in OSCC and GC. For stage, similar trends existed between genders; decreasing regional and increasing localised, distant disease. Five-year survival improved in OAC, 12.8% to 26.8% (males 11.2% to 25.8%, females 21.9% to 32.1%), and GC, 25.0% to 30.7% (males 23% to 28.2%, females 28.6% to 34.4%). OSCC 5-year survival increased, 17.4% to 20.3% (males 14.4% to 20.8%, females 21.7% to 19.6%). Mortality declined by 2.4% in OSCC (males -2.4%, females -2.5%) and 3.3% in GC (males -3.8%, females -2.7%) but increased in OAC 0.8% annually (males 0.6%, females 0.5%). Mortality declined in OSCC and GC, but increased for OAC, largely driven by incidence
Conclusion: Findings suggest gender-specific trends. Incidence of OAC was rising faster in males, but declining similarly for both sexes in OSCC and GC. Changes in mortality were driven by incidence, rather than incremental improvements in survival. To improve mortality, measures to reduce the incidence of OSCC and GC, and arrest the increase in OAC, including addressing gender differences, are needed.