Esophageal cancer global burden profiles, trends, and contributors

Abstract

Objective: This study aimed to provide a comprehensive overview of the global burden of esophageal cancer (EC) and determine the temporal trends and factors influencing changes in the global burden.

Methods: The latest incidence and mortality data for EC worldwide were obtained from GLOBALCAN 2022. The mortality and disability-adjusted life years (DALYs) rates for EC from 1990-2019 were sourced from the 2019 Global Burden of Diseases. Trends in EC mortality and DALYs attributable to 11 risk factors or clusters of risk were analyzed using the joinpoint regression model. The trends in age-related EC burden were assessed using a decomposition approach.

Results: An estimated 511,054 new cases of EC were diagnosed in 2022 with 445,391 deaths worldwide. Approximately 75% of cases and deaths occurred in Asia. Nearly 50% of global EC deaths and DALYs were attributed to tobacco use in men in 2019, while 20% were attributed to high body mass index (BMI) in women. From 1990-2019, EC deaths and DALYs attributable to almost all risk factors had declining trends, while EC deaths and DALYs attributed to high BMI in men had upward trends. The age-related EC burden exhibited an upward trend driven by population growth and aging, which contributed to 307.4 thousand deaths and 7.2 million DALYs due to EC.

Conclusions: The EC burden remains substantial worldwide. Effective tobacco and obesity control measures are critical for addressing the risk-attributable burden of EC. Population growth and aging pose challenges for EC prevention and control efforts.

Keywords: Esophageal cancer; aging; disability-adjusted life years; incidence; mortality; risk factors; trends.

Figure 1

Country-level esophageal cancer incidence and mortality rates by four-tier HDI, 2022. (A) Country-level esophageal cancer incidence rates for males. (B) Country-level esophageal cancer mortality rates for males. (C) Country-level esophageal cancer incidence rates for females. (D) Country-level esophageal cancer mortality rates for females. HDI, human development index.

Figure 2

Trends in risk for esophageal cancer incidence mortality and DALY rates for esophageal cancer by SDI and GBD regions, 1990–2019. The size of the point indicates a logarithmic transformation after normalization to age-standardized mortality and DALY rates. The color of the point indicates the average annual percent change of age-standardized mortality and DALY rates. (A) Trends in risk-attributable age-standardized mortality rates for males. (B) Trends in risk-attributable age-standardized DALY rates for males. (C) Trends in risk-attributable age-standardized mortality rates for females. (D) Trends in risk-attributable age-standardized DALY rates for females. DALY, disability-adjusted life-years; SDI, socio-demographic index; GBD, global burden of diseases; AAPC, average annual percent change.

Figure 3

Decomposition of changes in age-related deaths and DALYs due to esophageal cancer between 1990 and 2019, by SDI and GBD regions. (A) Decomposition of changes in age-related deaths for males. (B) Decomposition of changes in age-related DALYs for males. (C) Decomposition of changes in age-related deaths for females. (D) Decomposition of changes in age-related DALYs for females. DALYs, disability-adjusted life-years; SDI, socio-demographic index; GBD, global burden of diseases.