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. 2021 Mar;10(5):1889-1899.
doi: 10.1002/cam4.3775. Epub 2021 Feb 14.

Changing trends in the disease burden of esophageal cancer in China from 1990 to 2017 and its predicted level in 25 years

Songbo Li  1   2 , Hui Chen  1   3 , Jinyu Man  4 , Tongchao Zhang  4 , Xiaolin Yin  4 , Qiufeng He  4 , Xiaorong Yang  1   2   3 , Ming Lu  1   3   4
Affiliations

Changing trends in the disease burden of esophageal cancer in China from 1990 to 2017 and its predicted level in 25 years

Songbo Li et al. Cancer Med. 2021 Mar.

Abstract

Background: Nearly half of the cases of esophageal cancer in the world were in China, but the corresponding burden in China has not been estimated for the past decades or for the near future.

Methods: Data on the incidence, mortality, and disability-adjusted life years (DALYs) rates owing to esophageal cancer in China from 1990 to 2017 were extracted from the Global Burden of Disease Study 2017. To reflect the trend in the disease burden, we calculated the estimated annual percentage change (EAPC) in the age-standardized rates of these three outcomes in China from 1990 to 2017.

Results: The age-standardized incidence rate (ASIR) for esophageal cancer decreased from 19.38/100,000 in 1990 to 12.23/100,000 in 2017, with an EAPC of -2.53 (95%CI: -2.90, -2.16), but the number of cases of esophageal cancer increased from 164,473 to 234,624. The age-standardized rates of esophageal cancer in females were always lower than they were in males during the study period, and there was a downward trend that was more pronounced among females than males. The most common risk factors for males were smoking and alcohol consumption, while the most common risk factors for females were a diet low in fruits and a high body mass index (BMI). New cases of, and deaths from esophageal cancer are predicted to increase by about 1.5 times in the coming 25 years.

Conclusion: Although the age-standardized burden of esophageal cancer has been declining, the number of new cases of, and deaths from esophageal cancer have increased in China over the past 30 years, and they will continue to increase in the near future. Hence, national policies should be adopted to promote the prevention and management of known risk factors for it, especially smoking and excessive caloric intake.

Keywords: disease burden; esophageal cancer; prediction; risk factors; trend.

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Conflict of interest statement

The authors state that the study was conducted without any commercial or financial relationships, which may be interpreted as potential conflicts of interest.

Figures

FIGURE 1
FIGURE 1
The national numbers and age‐standardized rates of incidence (A), mortality (B), and DALYs (C) of esophageal cancer per 100,000 population by age and sex, 2017 Shading indicates the upper and lower limits of the 95% uncertainty intervals (95% UIs). DALYs, disability‐adjusted life‐year
FIGURE 2
FIGURE 2
The incident number (A), incidence rate (B), deaths number (C), death rate (D), DALYs number (E), and DALYs rate (F) of esophageal cancer per 100,000 population by sex in different age groups, from 1990 to 2017. DALYs, disability‐adjusted life‐year
FIGURE 3
FIGURE 3
Proportions of DALYs attributable to risk factors by age and sex in 2017
FIGURE 4
FIGURE 4
Proportions of esophageal cancer due to specific risk factors in China from 1990 to 2017
FIGURE 5
FIGURE 5
DALY rates of esophageal cancer due to specific risk factors by sex in different age groups in China from 1990 to 2017
FIGURE 6
FIGURE 6
Trends in esophageal cancer incidence and death rates by sex in China: observed (solid lines) and predicted rates (dashed lines) (A). Trends in observed (dashed lines) and predicted (solid lines) esophageal cancer in number of incidence cases (B) and deaths(C). Shading indicates if the rate remained stable (baseline reference), decreased by 1% per year (optimistic reference, lower limit), and increased by 1% per year (pessimistic reference, upper limit) based on the observed rate in 2017
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