LIU Qian 1 , LIU Na 1 , DING Ziyuan 2 , MA Jianfeng 3 , WANG Yongfeng 3 , LI Sheng 4
  • 1. School of Public Health of Lanzhou University, Lanzhou 730000, P. R. China;
  • 2. The Second Clinical Medical College of Lanzhou University, Lanzhou 730000, P. R. China;
  • 3. The First Clinical Medical College of Lanzhou University, Lanzhou 730000, P. R. China;
  • 4. The First People’s Hospital of Lanzhou, Lanzhou 730000, P. R. China;
LI Sheng, Email: doctorlisheng@163.com
Esophageal cancer; Disease burden; China; Joinpoint regression model
10.7507/1672-2531.202503169
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Objective  To analyze the spatiotemporal evolution characteristics of the disease burden of esophageal cancer in China from 2001 to 2021, and provide scientific evidence for optimizing public health intervention strategies. Methods  Data were derived from the Global Burden of Diseases (GBD 2021) database, extracting indicators including incidence, prevalence, mortality, disability-adjusted life year (DALY) rate, and years of life lost (YLL) rate for esophageal cancer in China. The Joinpoint regression model was employed to assess long-term trends in disease burden across genders and age groups, combined with age-standardization using the GBD world standard population. Average annual percentage change (AAPC) and 95% confidence intervals (CI) were calculated, and Excel 2019 was used for data collation and descriptive statistics. Results  In 2021, the crude incidence, prevalence, and mortality rates of esophageal cancer in China were 22.55, 38.37, and 20.26 per 100 000 population, respectively, representing increases of 13.49%, 23.41%, and 1.30% compared to 2001. The DALY and YLL rates were 450.14 and 436.29 per 100 000, decreasing by 18.01% and 16.10% over the same period. Significant gender disparities were observed, with males exhibiting higher age-standardized incidence, prevalence, mortality, DALY, and YLL rates than females. In 2021, the male age-standardized incidence (34.29/100 000) and mortality (31.06/100 000) rates were 3.3 and 3.5 times those of females, respectively. Disease burden increased exponentially with age, peaking in the 70 to 74-year-old group for incidence, prevalence, and DALY rates, with males showing significantly higher values than females. Trend analysis of standardized rates revealed significant declines from 2001 to 2021, with AAPC values of −2.03% for incidence, −1.42% for prevalence, −2.57% for mortality, and −2.84% for DALY rate (all P<0.05). Conclusion  The age-standardized disease burden of esophageal cancer in China has decreased over the past two decades, while crude rates have continued to rise, with a pronounced burden among males and older populations. Against the backdrop of accelerating population aging, targeted early screening, behavioral interventions, and optimized resource allocation are imperative to address the challenges in preventing and controlling esophageal cancer.

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