Latest insights into the global epidemiological features, screening, early diagnosis and prognosis prediction of esophageal squamous cell carcinoma

Abstract

As a highly invasive carcinoma, esophageal cancer (EC) was the eighth most prevalent malignancy and the sixth leading cause of cancer-related death worldwide in 2020. Esophageal squamous cell carcinoma (ESCC) is the major histological subtype of EC, and its incidence and mortality rates are decreasing globally. Due to the lack of specific early symptoms, ESCC patients are usually diagnosed with advanced-stage disease with a poor prognosis, and the incidence and mortality rates are still high in many countries, especially in China. Therefore, enormous challenges still exist in the management of ESCC, and novel strategies are urgently needed to further decrease the incidence and mortality rates of ESCC. Although the key molecular mechanisms underlying ESCC pathogenesis have not been fully elucidated, certain promising biomarkers are being investigated to facilitate clinical decision-making. With the advent and advancement of high-throughput technologies, such as genomics, proteomics and metabolomics, valuable biomarkers with high sensitivity, specificity and stability could be identified for ESCC. Herein, we aimed to determine the epidemiological features of ESCC in different regions of the world, especially in China, and focused on novel molecular biomarkers associated with ESCC screening, early diagnosis and prognosis prediction.

Keywords: Diagnosis; Epidemiology; Esophageal squamous cell carcinoma; Genomics; Metabolomics; Proteomics.

Figure 1

The proportions of incidences and mortalities of all cancer types in 2020 worldwide. A: The proportions of incidences of all cancer types in 2020 worldwide; B: The proportions of mortalities of all cancer types in 2020 worldwide. Bar plots show the proportions of incidences or mortalities of all cancer types in both sexes, males and females, respectively. The data source for constructions were from website GLOBOCAN 2020 (https://gco.iarc.fr/today).

Figure 2

Estimated age-standardized incidence and mortality rates of esophageal cancer in 2020 worldwide. A: Estimated age-standardized incidence rates of esophageal cancer in 2020 worldwide; B: Estimated age-standardized mortality rates of esophageal cancer in 2020 worldwide. Bar plots show the estimated age-standardized incidence rates and estimated age-standardized mortality rates of esophageal cancer in both sexes, males and females, respectively. The data source for constructions were from website GLOBOCAN 2020 (https://gco.iarc.fr/today).

Figure 3

Estimated age-standardized incidence and mortality rates of esophageal cancer in 2020 in Asia. A: Estimated age-standardized incidence rates of esophageal cancer in 2020 in Asia; B: Estimated age-standardized incidence rates of esophageal cancer in males in 2020 in Asia; C: Estimated age-standardized incidence rates of esophageal cancer in females in 2020 in Asia; D: Estimated age-standardized mortality rates of esophageal cancer in 2020 in Asia; E: Estimated age-standardized mortality rates of esophageal cancer in males in 2020 in Asia; F: Estimated age-standardized mortality rates of esophageal cancer in females in 2020 in Asia. A-F: They were constructed by six separate figures published on the website GLOBOCAN 2020. The data source is from GLOBOCAN 2020 (https://gco.iarc.fr/), and the map production is from IARC/WHO (https://gco.iarc.fr/today). IARC exercises copyright over its materials, and all rights are reserved. A request for permission to reproduce IARC copyrighted material was sent and a copyright permission to reprint and reproduce the IARC/WHO copyrighted materials in this paper is authorized by IARC/WHO. And a legal agreement between authors for this paper and IARC/WHO is acquired, granting authors a license to use the Licensed Materials subject to this paper herein (Supplementary material).

Figure 4

Summary of risk factors associated with esophageal squamous cell carcinoma.

Figure 5

Trends in age-standardized incidence and mortality rates of esophageal cancer in China from 1990 to 2019, according to the Global Burden of Disease Study 2019 database. A: Trends in age-standardized incidence rates of esophageal cancer in China from 1990 to 2019, according to the Global Burden of Disease Study 2019 (GBD 2019); B: Trends in age-standardized mortality rates of esophageal cancer in China from 1990 to 2019, according to the GBD 2019. Line charts show the trends in age-standardized incidence and mortality rates of esophageal cancer in China from 1990 to 2019 in both sexes, males and females, respectively. Source: Institute for Health Metrics and Evaluation. Global Burden of Disease Collaborative Network, Global Burden of Disease Study 2019 Results, Seattle, United States: Institute for Health Metrics and Evaluation, 2020. Available from https://vizhub.healthdata.org/gbd-results/.