Authors
Farin Kamangar
Dariush Nasrollahzadeh
Saeid Safiri
Sadaf G. Sepanlou
Christina Fitzmaurice
Kevin S. Ikuta
Catherine Bisignano
Farhad Islami
Gholamreza Roshandel
Stephen S. Lim
Hassan Abolhassani
Eman Abu-Gharbieh
Rufus Adesoji Adedoyin
Shailesh M. Advani
Muktar Beshir Ahmed
Miloud Taki Eddine Aichour
Tomi Akinyemiju
Chisom Joyqueenet Akunna
Fares Alahdab
Vahid Alipour
Amir Almasi-Hashiani
Abdulaziz M. Almulhim
Nahla Hamed Anber
Alireza Ansari-Moghaddam
Jalal Arabloo
Morteza Arab-Zozani
Atalel Fentahun Awedew
Alaa Badawi
Kathleen S. Sachiko Berfield
Kidanemaryam Berhe
Krittika Bhattacharyya
Antonio Biondi
Tone Bjørge
Antonio M. Borzì
Cristina Bosetti
Giulia Carreras
Felix Carvalho
Clara Castro
Dinh-Toi Chu
Vera Marisa Costa
Baye Dagnew
Jiregna Darega Gela
Ahmad Daryani
Feleke Mekonnen Demeke
Gebre Teklemariam Demoz
Mostafa Dianatinasab
Iffat Elbarazi
Mohammad Hassan Emamian
Arash Etemadi
Pawan Sirwan Faris
Eduarda Fernandes
Irina Filip
Florian Fischer
Mohamed M. Gad
Silvano Gallus
Abadi Kahsu Gebre, Edith Cowan UniversityFollow
Tsegaye Tewelde Gebrehiwot
Gebreamlak Gebremedhn Gebremeskel
Begashaw Melaku Gebresillassie
Fatemah Ghasemi-Kebria
Ahmad Ghashghaee
Nermin Ghith
Mahaveer Golechha
Giuseppe Gorini
Rahul Gupta
Nima Hafezi-Nejad
Arvin Haj-Mirzaian
James D. Harvey
Maryam Hashemian
Hamid Yimam Hassen
Simon I. Hay
Andualem Henok
Chi Linh Hoang
H. Dean Hosgood
Mowafa Househ
Olayinka Stephen Ilesanmi
Milena D. Ilic
Seyed Sina Naghibi Irvani
Charvi Jain
Spencer L. James
Sun Ha Jee
Ravi Prakash Jha
Farahnaz Joukar
Ali Kabir
Amir Kasaeian
Mesfin Wudu Kassaw
Supreet Kaur
Andre Pascal Kengne
Esma Kerboua
Yousef Saleh Khader
Rovshan Khalilov
Ejaz Ahmad Khan
Abdullah T. Khoja
Jonathan M. Kocarnik
Hamidreza Komaki
Vivek Kumar
Carlo La Vecchia
Savita Lasrado
Bingyu Li
Alan D. Lopez
Azeem Majeed
Navid Manafi
Ana Laura Manda
Fariborz Mansour-Ghanaei
Manu Raj Mathur
Varshil Mehta
Dhruv Mehta
Walter Mendoza
Prasanna Mithra
Karzan Abdulmuhsin Mohammad
Abdollah Mohammadian-Hafshejani
Reza Mohammadpourhodki
Jemal Abdu Mohammed
Farnam Mohebi
Ali H. Mokdad
Lorenzo Monasta
Delaram Moosavi
Mahmood Moosazadeh
Ghobad Moradi
Farhad Moradpour
Rahmatollah Moradzadeh
Gurudatta Naik
lonut Negoi
Haruna Asura Nggada
Huong Lan Thi Nguyen
Rajan Nikbakhsh
Molly R. Nixon
Andrew T. Olagunju
Jagadish Roa. Padubidri
Keyvan Pakshir
Shanti Patel
Mona Pathak
Hai Quang Pham
Akram Pourshams
Navid Rabiee
Mohammad Rabiee
Amir Radfar
Alireza Rafiei
Kiana Ramezanzadeh
Goura Kishor Rath
Priya Rathi
Salman Rawaf
David Laith Rawaf
Nima Rezaei
Elias Merdassa Roro
Anas M. Saad
Hamideh Salimzadeh
Abdallah M. Samy
Benn Sartorius
Arash Sarvaezad
Mario Sekerija
Feng Sha
Morteza Shamsizadeh
Sara Sheikhbahaei
Reza Shirkoohi
Sudeep K. Siddappa Malleshappa
Jasvinder A. Singh
Dhirendra Narain Sinha
Catalin-Gabriel Smarandache
Sergey Soshnikov
Hafiz Ansar Rasul Suleria
Degena Bahrey Tadesse
Berhe Etsay Tesfay
Bhaskar Thakur
Eugenio Traini
Khanh Bao Tran
Bach Xuan Tran
Irfan Ullah
Marco Vacante
Yousef Veisani
Isidora S. Vujcic
Girmay Teklay Weldesamuel
Rixing Xu
Vahid Yazdi-Feyzabadi
Deniz Yuce
Vesna Zadnik
Zoubida Zaidi
Zhi-Jiang Zhang
Reza Malekzadeh
Mohsen Naghavi
GBD 2017 Oesophageal Cancer Collaborators
Document Type
Journal Article
Publication Title
The Lancet Gastroenterology and Hepatology
ISSN
24681253
Volume
5
Issue
6
First Page
582
Last Page
597
Publisher
Elsevier
School
School of Medical and Health Sciences
Funders
Bill and Melinda Gates Foundation
Abstract
© 2020 The Author(s). Background Oesophageal cancer is a common and often fatal cancer that has two main histological subtypes: oesophageal squamous cell carcinoma and oesophageal adenocarcinoma. Updated statistics on the incidence and mortality of oesophageal cancer, and on the disability-adjusted life-years (DALYs) caused by the disease, can assist policy makers in allocating resources for prevention, treatment, and care of oesophageal cancer. We report the latest estimates of these statistics for 195 countries and territories between 1990 and 2017, by age, sex, and Socio-demographic Index (SDI), using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD). Methods We used data from vital registration systems, vital registration-samples, verbal autopsy records, and cancer registries, combined with relevant modelling, to estimate the mortality, incidence, and burden of oesophageal cancer from 1990 to 2017. Mortality-to-incidence ratios (MIRs) were estimated and fed into a Cause of Death Ensemble model (CODEm) including risk factors. MIRs were used for mortality and non-fatal modelling. Estimates of DALYs attributable to the main risk factors of oesophageal cancer available in GBD were also calculated. The proportion of oesophageal squamous cell carcinoma to all oesophageal cancers was extracted by use of publicly available data, and its variation was examined against SDI, the Healthcare Access and Quality (HAQ) Index, and available risk factors in GBD that are specific for oesophageal squamous cell carcinoma (eg, unimproved water source and indoor air pollution) and for oesophageal adenocarcinoma (gastro-oesophageal reflux disease). Findings There were 473 000 (95% uncertainty interval [95% UI] 459 000-485 000) new cases of oesophageal cancer and 436 000 (425 000-448 000) deaths due to oesophageal cancer in 2017. Age-standardised incidence was 5.9 (5.7-6.1) per 100 000 population and age-standardised mortality was 5.5 (5.3-5.6) per 100 000. Oesophageal cancer caused 9.78 million (9.53-10.03) DALYs, with an age-standardised rate of 120 (117-123) per 100 000 population. Between 1990 and 2017, age-standardised incidence decreased by 22.0% (18.6-25.2), mortality decreased by 29.0% (25.8-32.0), and DALYs decreased by 33.4% (30.4-36.1) globally. However, as a result of population growth and ageing, the total number of new cases increased by 52.3% (45.9-58.9), from 310 000 (300 000-322 000) to 473 000 (459 000-485 000); the number of deaths increased by 40.0% (34.1-46.3), from 311 000 (301 000-323 000) to 436 000 (425 000-448 000); and total DALYs increased by 27.4% (22.1-33.1), from 7.68 million (7.42-7.97) to 9.78 million (9.53-10.03). At the national level, China had the highest number of incident cases (235 000 [223 000-246 000]), deaths (213 000 [203 000-223 000]), and DALYs (4.46 million [4.25-4.69]) in 2017. The highest national-level agestandardised incidence rates in 2017 were observed in Malawi (23.0 [19.4-26.5] per 100 000 population) and Mongolia (18.5 [16.4-20.8] per 100 000). In 2017, age-standardised incidence was 2.7 times higher, mortality 2.9 times higher, and DALYs 3.0 times higher in males than in females. In 2017, a substantial proportion of oesophageal cancer DALYs were attributable to known risk factors: tobacco smoking (39.0% [35.5-42.2]), alcohol consumption (33.8% [27.3-39.9]), high BMI (19.5% [6.3-36.0]), a diet low in fruits (19.1% [4.2-34.6]), and use of chewing tobacco (7.5% [5.2-9.6]). Countries with a low SDI and HAQ Index and high levels of indoor air pollution had a higher proportion of oesophageal squamous cell carcinoma to all oesophageal cancer cases than did countries with a high SDI and HAQ Index and with low levels of indoor air pollution. Interpretation Despite reductions in age-standardised incidence and mortality rates, oesophageal cancer remains a major cause of cancer mortality and burden across the world. Oesophageal cancer is a highly fatal disease, requiring increased primary prevention efforts and, possibly, screening in some high-risk areas. Substantial variation exists in age-standardised incidence rates across regions and countries, for reasons that are unclear.
DOI
10.1016/S2468-1253(20)30007-8
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Kamangar, F., Nasrollahzadeh, D., Safiri, S., Sepanlou, S. G., Fitzmaurice, C., Ikuta, K. S., … Naghavi, M. (2020). The global, regional, and national burden of oesophageal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: A systematic analysis for the global burden of disease study 2017. The Lancet Gastroenterology & Hepatology, 5(6), 582-597. https://doi.org/10.1016/S2468-1253(20)30007-8