Abstract / Summary
Esophageal cancer (EC) is the sixth leading cause of cancer-related mortality worldwide, and analyzing its most recent disease trends is essential for effective prevention and control strategies. Data on the global burden of EC were obtained from the 2021 Global Burden of Disease study, including prevalence, incidence, mortality, disability-adjusted life years (DALYs), and attributable risk factors. Age-standardized rates were calculated for each indicator, and estimated annual percentage change was used to assess temporal trends in ASRs from 1990 to 2021. Analyses were stratified by age group (20–54 years and ≥55 years), sex, and socio demographic index. Joinpoint regression was applied to estimate annual percentage change, and a Bayesian age-period-cohort model was constructed to project the disease burden from 2021 to 2050. In 2021, the age-standardized prevalence rate of EC was 11.474 (95% uncertainty intervals [UI]: 10.151–12.803) per 100,000 population, representing a 13.96% decrease compared with 1990. The age-standardized incidence rate was 6.655 (95% UI: 5.883–7.45) per 100,000 population, declining by 24.86%. The age-standardized mortality rate was 6.255 (95% UI: 5.527–7.003) per 100,000 population, a reduction of 30.67%, while the age-standardized DALYs rate was 148.561 (95% UI: 131.709–166.818) per 100,000 population, corresponding to a 36.87% decrease. The disease burden was particularly pronounced in Turkmenistan. Overall, the burden of EC was higher in males than in females and increased with age, peaking in the 65 to 69 years age group. Regarding risk factors, tobacco use, high alcohol consumption, and dietary risks were the leading contributors to global EC-related deaths and DALYs. The most substantial declines in EC burden occurred in the years following 2004. Projections indicate that by 2050, the DALYs burden attributable to EC will decrease markedly. These findings demonstrate that age‑standardized rates of global EC burden have declined over the past 3 decades, despite rising absolute disease counts. Targeted strategies to improve EC management should prioritize men, particularly those aged 65 to 69 years. Moreover, a comprehensive understanding of the risk factors contributing to EC burden is critical for the development and implementation of effective public health policies, which will further contribute to reducing the global burden of EC.