Burden, patterns, and risk factors of esophageal cancer mortality in China, 2008-2021: a national mortality surveillance system data analysis

Background: Globally, China has the highest burden of esophageal cancer (EC). This study aims to analyze the trends and patterns of EC deaths in China. Methods: Data from the National Mortality Surveillance System were used to estimate national and provincial deaths, age-standardized mortality rate...

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Main Authors: Yunfei Jiao, Tinglu Wang, Lin Fu, Ye Gao, Zhiyuan Cheng, Lei Xin, Jinfang Xu, Han Lin, Wei Wang, Maigeng Zhou, Jinlei Qi, Zhaoshen Li, Luowei Wang
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:The Lancet Regional Health. Western Pacific
Online Access:http://www.sciencedirect.com/science/article/pii/S2666606524004401
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author Yunfei Jiao
Tinglu Wang
Lin Fu
Ye Gao
Zhiyuan Cheng
Lei Xin
Jinfang Xu
Han Lin
Wei Wang
Maigeng Zhou
Jinlei Qi
Zhaoshen Li
Luowei Wang
author_facet Yunfei Jiao
Tinglu Wang
Lin Fu
Ye Gao
Zhiyuan Cheng
Lei Xin
Jinfang Xu
Han Lin
Wei Wang
Maigeng Zhou
Jinlei Qi
Zhaoshen Li
Luowei Wang
author_sort Yunfei Jiao
collection DOAJ
description Background: Globally, China has the highest burden of esophageal cancer (EC). This study aims to analyze the trends and patterns of EC deaths in China. Methods: Data from the National Mortality Surveillance System were used to estimate national and provincial deaths, age-standardized mortality rate (ASMR), and years of life lost (YLL), which covered 605 disease surveillance points (DSPs) after 2013 and 161 DSPs before 2012 in mainland China. Joinpoint models were performed to calculate the average annual percent change (AAPC) by fitting the simplest joinpoint models (0 joinpoint). An age-period-cohort-based Nordpred model was used to predict trends until 2030. Multilevel Poisson and logistic regressions were used to assess factors influencing EC deaths, regional mortality and place of death. Findings: From 2008 to 2021, EC deaths and YLLs decreased from 227,677 to 167,529 (AAPC -2.19), and from 5.32 million to 3.50 million (AAPC -2.98). Meanwhile, ASMR and age-standardized YLL rate decreased from 24.34 to 11.01 per 100,000 (AAPC -5.49), and from 535.91 and 231.08 per 100,000 (AAPC -5.99). By 2030, EC deaths and ASMR are predicted to decline to 150,768 and 7.85 per 100,000. Nationwide, the average age at death increased from 68.46 to 72.45 years. Overall premature mortality was observed to decrease, except for increasing YLLs in urban populations aged ≥60 years. A substantial increase in the percentage of premature mortality burden occurred among older adults aged 65 years and older (63.62% in 2021; AAPC 2.40). Moreover, significant geographic variations were observed, ranging from ASMR of 2.84 (Xizang) to 21.62 (Jiangsu) per 100,000 in 2021. Higher burden was observed in rural than urban areas (2.01-fold), and among males than females (3.00-fold). Nationwide, individuals with agriculture-related occupations and low educational levels had significantly high risks of EC death. Regions with higher prevalences of smoking and harmful drinking, and low educational, economic, and medical levels were significantly associated with high mortality. Home was the leading place of EC deaths (80.02%). Interpretation: The EC mortality burden is decreasing in China but remains significant threats to public health. Promoting education, occupational prevention, healthy lifestyles, and medical treatment for targeted populations and regions is required. Funding: This research was supported by the Science and Technology Commission of Shanghai Municipality (21Y31900100).
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spelling doaj-art-1af3a86cdaea44fcb9c2286a40939d352025-08-20T03:11:40ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652025-02-015510144610.1016/j.lanwpc.2024.101446Burden, patterns, and risk factors of esophageal cancer mortality in China, 2008-2021: a national mortality surveillance system data analysisYunfei Jiao0Tinglu Wang1Lin Fu2Ye Gao3Zhiyuan Cheng4Lei Xin5Jinfang Xu6Han Lin7Wei Wang8Maigeng Zhou9Jinlei Qi10Zhaoshen Li11Luowei Wang12Changhai Hospital, Department of Gastroenterology, China; National Clinical Research Center for Digestive Diseases, Shanghai, ChinaChanghai Hospital, Department of Gastroenterology, China; National Clinical Research Center for Digestive Diseases, Shanghai, ChinaNational Clinical Research Center for Digestive Diseases, Shanghai, China; Department of Gastroenterology, The Second Affiliated Hospital of Baotou Medical College, ChinaChanghai Hospital, Department of Gastroenterology, China; National Clinical Research Center for Digestive Diseases, Shanghai, ChinaNational Clinical Research Center for Digestive Diseases, Shanghai, China; Department of Gastroenterology, Shanghai General Hospital, ChinaChanghai Hospital, Department of Gastroenterology, China; National Clinical Research Center for Digestive Diseases, Shanghai, ChinaNaval Medical University, Department of Health Statistics, ChinaChanghai Hospital, Department of Gastroenterology, China; National Clinical Research Center for Digestive Diseases, Shanghai, ChinaChanghai Hospital, Department of Gastroenterology, China; National Clinical Research Center for Digestive Diseases, Shanghai, ChinaNational Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, ChinaNational Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, ChinaChanghai Hospital, Department of Gastroenterology, China; National Clinical Research Center for Digestive Diseases, Shanghai, ChinaChanghai Hospital, Department of Gastroenterology, China; National Clinical Research Center for Digestive Diseases, Shanghai, ChinaBackground: Globally, China has the highest burden of esophageal cancer (EC). This study aims to analyze the trends and patterns of EC deaths in China. Methods: Data from the National Mortality Surveillance System were used to estimate national and provincial deaths, age-standardized mortality rate (ASMR), and years of life lost (YLL), which covered 605 disease surveillance points (DSPs) after 2013 and 161 DSPs before 2012 in mainland China. Joinpoint models were performed to calculate the average annual percent change (AAPC) by fitting the simplest joinpoint models (0 joinpoint). An age-period-cohort-based Nordpred model was used to predict trends until 2030. Multilevel Poisson and logistic regressions were used to assess factors influencing EC deaths, regional mortality and place of death. Findings: From 2008 to 2021, EC deaths and YLLs decreased from 227,677 to 167,529 (AAPC -2.19), and from 5.32 million to 3.50 million (AAPC -2.98). Meanwhile, ASMR and age-standardized YLL rate decreased from 24.34 to 11.01 per 100,000 (AAPC -5.49), and from 535.91 and 231.08 per 100,000 (AAPC -5.99). By 2030, EC deaths and ASMR are predicted to decline to 150,768 and 7.85 per 100,000. Nationwide, the average age at death increased from 68.46 to 72.45 years. Overall premature mortality was observed to decrease, except for increasing YLLs in urban populations aged ≥60 years. A substantial increase in the percentage of premature mortality burden occurred among older adults aged 65 years and older (63.62% in 2021; AAPC 2.40). Moreover, significant geographic variations were observed, ranging from ASMR of 2.84 (Xizang) to 21.62 (Jiangsu) per 100,000 in 2021. Higher burden was observed in rural than urban areas (2.01-fold), and among males than females (3.00-fold). Nationwide, individuals with agriculture-related occupations and low educational levels had significantly high risks of EC death. Regions with higher prevalences of smoking and harmful drinking, and low educational, economic, and medical levels were significantly associated with high mortality. Home was the leading place of EC deaths (80.02%). Interpretation: The EC mortality burden is decreasing in China but remains significant threats to public health. Promoting education, occupational prevention, healthy lifestyles, and medical treatment for targeted populations and regions is required. Funding: This research was supported by the Science and Technology Commission of Shanghai Municipality (21Y31900100).http://www.sciencedirect.com/science/article/pii/S2666606524004401
spellingShingle Yunfei Jiao
Tinglu Wang
Lin Fu
Ye Gao
Zhiyuan Cheng
Lei Xin
Jinfang Xu
Han Lin
Wei Wang
Maigeng Zhou
Jinlei Qi
Zhaoshen Li
Luowei Wang
Burden, patterns, and risk factors of esophageal cancer mortality in China, 2008-2021: a national mortality surveillance system data analysis
The Lancet Regional Health. Western Pacific
title Burden, patterns, and risk factors of esophageal cancer mortality in China, 2008-2021: a national mortality surveillance system data analysis
title_full Burden, patterns, and risk factors of esophageal cancer mortality in China, 2008-2021: a national mortality surveillance system data analysis
title_fullStr Burden, patterns, and risk factors of esophageal cancer mortality in China, 2008-2021: a national mortality surveillance system data analysis
title_full_unstemmed Burden, patterns, and risk factors of esophageal cancer mortality in China, 2008-2021: a national mortality surveillance system data analysis
title_short Burden, patterns, and risk factors of esophageal cancer mortality in China, 2008-2021: a national mortality surveillance system data analysis
title_sort burden patterns and risk factors of esophageal cancer mortality in china 2008 2021 a national mortality surveillance system data analysis
url http://www.sciencedirect.com/science/article/pii/S2666606524004401
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