Esophageal or gastroesophageal junction cancer (EC/GEJC) | Primary Research (KOL's Insight) | Market Intelligence | Epidemiology & Market Forecast-2035

Due to the GEJ's position between the oesophagus and the stomach, GEJ cancers have historically been categorized as either oesophageal or gastric tumors, which has caused controversy and disagreement about the classification. A few other names for GEJ tumours include distal oesophageal cancers, proximal gastric cancers, and cancers of the heart. Distal oesophageal cancer is the most prevalent type of esophageal cancer in the United States, and GEJ tumour incidence has sharply increased in Western populations. The incidence of proximal gastric cancer has increased, while that of distal gastric cancer has decreased. Depending on the stage (locoregional, stages I-III, versus metastatic, stage IV) and histologic subtype (squamous cell carcinoma (SCC), versus adenocarcinoma), esophageal cancer is treated differently. Endoscopic therapy is preferred for high-grade dysplasia (HGD) or T1a tumors that are less than 2 cm in size; ablation alone is the main treatment choice for patients with HGD.

Description

Due to their location between the oesophagus and the stomach, GEJ cancers have historically been categorized as either oesophageal or gastric tumours, which has generated controversy and disagreement about this classification. There are numerous other names for GEJ tumours, including distal oesophageal cancers, proximal gastric cancers, and cancers of the heart. According to the study, this has led to differences in the prognosis, surgical approach, pathogenesis, and categorization. In the Siewert et al. is the definition that applies to GEJ cancer the most. They succeeded in separating the tumors from oesophageal or gastric malignancies and giving them their own classification. His recommendation was to classify GEJ tumors as either having the cancer's epicentre 5 cm away from or close to the Z-line. The Union for International Cancer Control (UICC) has adopted a similar definition and advises that tumors with oesophageal extension should be classified and staged using an oesophageal scheme, while those without oesophageal extension should be staged using the gastric cancer scheme, even if they are located within 5 cm of the GEJ. The American Joint Committee on Cancer (AJCC) advises staging GEJ cancers that have their epicentres more than 2 cm distal from the cardia as gastric cancers and staging GEJ cancers that have their epicentres less than 2 cm distal from the cardia as oesophageal tumours (Siewert Type I/II).

Esophageal or gastroesophageal junction cancer (EC/GEJC) (Epidemiology)

In Western populations, the incidence of GEJ tumors has sharply increased, and distal oesophageal cancer is the most prevalent form of esophageal cancer in the USA. Similar to this, rates of distal gastric cancer have decreased while those of proximal gastric cancer have increased. In the USA, the incidence of GEJ tumors has increased 4% to 10% yearly since 1976. Comparatively higher than other Eastern centers like Japan and Korea, proximal gastric cancer, cancer of the cardia, and distal esophageal cancer accounted for about 30%-40% of total gastric carcinoma in Western countries and, oddly enough, in China. 783,000 people died from gastric cancer in 2018, according to estimates from the World Health Organization. There are significant regional differences in the incidence of this disease. The disease is most common in Asia and is least common in North America and Northern Europe (e. g. Japan, the Republic of Korea, and Mongolia). Western Asia's countries with the highest death rates include Iran, Turkmenistan, and Kyrgyzstan. By Arnold et al. Using information from 92 cancer registries in 34 countries representing 10 world regions, it was predicted that global incidence rates of gastric cancer will continue to decline in the majority of countries, including high-incidence nations like Japan and low-incidence nations like Australia. By 2035, rare diseases will be defined as having six cases per 100,000 person-years or fewer in 16 of those 34 countries. The total number of new cases of gastric cancer is expected to increase in the majority of countries, though. New cases may be slightly declining in some countries (like Bulgaria and Lithuania) while rising in others (like Canada, Cyprus, South Korea, Slovakia, and Thailand). By Arnold et al. 15 of 34 countries, including Belarus, Chile, the Netherlands, Canada, and the United Kingdom, predicted increases in incidence in people under 50. Arnold et al. found that incidence rates in people 50 years and older were consistently declining or stable. Incidence increases in people under 50 are anticipated. According to the American Cancer Society, there will be about 26,560 cases of stomach cancer diagnosed in 2021 (16,160 cases in men and 10,400 cases in women). The average patient is 68 years old when they receive a diagnosis. Gastric cancer is the fifteenth most common cancer in the US. Numerous population-based studies from Western countries have noted a sharp increase in the incidence of GEJ and esophageal cancer. It's interesting to note that GEJ adenocarcinoma incidence increased much more slowly than esophageal adenocarcinoma. These two types of adenocarcinomas can occasionally be confused with one another because of their similar risk factors.

Esophageal or gastroesophageal junction cancer (EC/GEJC) -Current Market Size & Forecast Trends

The market for esophageal and gastroesophageal junction cancer (EC/GEJC) is projected to see significant growth, with the global esophageal cancer market valued at approximately USD 1.34 billion in 2023 and expected to reach around USD 2.57 billion by 2031, reflecting a compound annual growth rate (CAGR) of 8.5% during the forecast period from 2024 to 2031. This growth is driven by increasing incidence rates, advancements in treatment options including chemotherapy, targeted therapies, and immunotherapies, as well as rising awareness of early detection methods.

Key trends influencing the market include the rising use of targeted therapies and the introduction of novel drugs such as Opdivo (nivolumab) for advanced esophageal squamous cell carcinoma, highlighting a shift towards personalized medicine. The Asia-Pacific region is expected to lead the market due to rapid healthcare development and a significant presence of generic manufacturers, while North America is anticipated to experience substantial growth driven by its strong research and development activities.

Overall, as new therapies continue to emerge and patient management strategies evolve, the esophageal cancer market is well-positioned for robust expansion through 2035, with further innovations likely to enhance treatment outcomes and patient quality of life.

Treatment for esophageal cancer varies depending on the histologic subtype (squamous cell carcinoma (SCC) versus adenocarcinoma) and stage (locoregional, stages I-III, versus metastatic, stage IV). Endoscopic therapy is preferred for high-grade dysplasia (HGD) or T1a tumors that are less than 2 cm in size; ablation alone is the main treatment choice for patients with HGD. Early tumors can sometimes be treated with endoscopic submucosal dissection (ESD), but advanced tumors require multimodal therapy, which frequently involves surgery. Surgery is typically used in conjunction with chemotherapy and/or radiation to treat locally advanced esophageal cancer. Chemotherapy is still the main treatment for metastatic disease in comparison to the best supportive care. The development of chemoresistance and the lack of efficient targeted therapies, such as those that target the HER2 and vascular endothelial growth factor pathways, make the prognosis for patients with GEJ cancers, which are managed using the same paradigms as esophageal and gastric carcinomas, still poor. Analysis of immune checkpoint inhibitors in the context of chemoresistance has shown that immunotherapy for esophagogastric cancer is effective.

Report Highlights

Esophageal or gastroesophageal junction cancer (EC/GEJC) - Current Market Trends

Esophageal or gastroesophageal junction cancer (EC/GEJC) - Current & Forecasted Cases across the G8 Countries

Esophageal or gastroesophageal junction cancer (EC/GEJC) - Market Opportunities and Sales Potential for Agents

Esophageal or gastroesophageal junction cancer (EC/GEJC) - Patient-based Market Forecast to 2035

Esophageal or gastroesophageal junction cancer (EC/GEJC) - Untapped Business Opportunities

Esophageal or gastroesophageal junction cancer (EC/GEJC) - Product Positioning Vis-a-vis Competitors' Products

Esophageal or gastroesophageal junction cancer (EC/GEJC) - KOLs Insight