Global burden of esophageal diseases: a comprehensive analysis of disease trends and risk factors from 1990 to 2021

Abstract Background Esophageal diseases (ED) are a common category of upper gastrointestinal disorders, mainly including gastroesophageal reflux disease (GERD), esophagitis, Barrett’s esophagus, achalasia, and esophageal cancer (EC). In recent years, the high recurrence rate of GERD and poor prognos...

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Main Authors: Yanbin Wei, Endian Liu, Jiafei Peng, Yanqing Liu, Xiujing Sun, Xin Yao
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-03988-8
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author Yanbin Wei
Endian Liu
Jiafei Peng
Yanqing Liu
Xiujing Sun
Xin Yao
author_facet Yanbin Wei
Endian Liu
Jiafei Peng
Yanqing Liu
Xiujing Sun
Xin Yao
author_sort Yanbin Wei
collection DOAJ
description Abstract Background Esophageal diseases (ED) are a common category of upper gastrointestinal disorders, mainly including gastroesophageal reflux disease (GERD), esophagitis, Barrett’s esophagus, achalasia, and esophageal cancer (EC). In recent years, the high recurrence rate of GERD and poor prognosis of EC are paid more attention, collectively contributing to the global burden of ED. Methods For this study, we systematically analyzed the global distribution of ED from 1990 to 2021, detailing the burden across different countries, regions, and socio-demographic index (SDI) levels. Furthermore, we explored temporal trends in ED burden over this period and conducted decomposition analysis, health inequality analysis, and frontier analysis. Finally, we projected trends in ED burden from 2022 to 2045, and quantify contributions of associated risk factors to disability-adjusted life years (DALYs) of EC. Results The absolute numbers of incidence, mortality, and DALYs for GERD and EC showed increasing trends from 1990 to 2021, while their age-standardized rates (ASRs) demonstrated divergent patterns: stable for GERD and declining for EC. The highest ASRs were observed in low-middle SDI regions for GERD and high-middle SDI regions for EC, respectively, with population as a main driver. If current trends continue, the burden of GERD will continue to rise, whereas that of EC will persistently decline by 2045. In 2021, DALYs of EC were mainly attributed to smoking (36.5%) and alcohol use (16.2%). Conclusions For GERD and EC, the global burden continued to rise and decline from 1990 to 2021, respectively. Developing targeted public health strategies in different countries and regions is crucial for alleviating the global burden of ED.
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spelling doaj-art-8699ff03913a4295bc63f2d8b9cbee0e2025-08-20T03:05:29ZengBMCBMC Gastroenterology1471-230X2025-07-0125112210.1186/s12876-025-03988-8Global burden of esophageal diseases: a comprehensive analysis of disease trends and risk factors from 1990 to 2021Yanbin Wei0Endian Liu1Jiafei Peng2Yanqing Liu3Xiujing Sun4Xin Yao5State Key Laboratory of Digestive Health, National Clinical Research Center for Digestive Disease, Beijing Key Laboratory of Early Gastrointestinal Cancer Medicine and Medical Devices, Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical UniversityState Key Laboratory of Digestive Health, National Clinical Research Center for Digestive Disease, Beijing Key Laboratory of Early Gastrointestinal Cancer Medicine and Medical Devices, Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical UniversityState Key Laboratory of Digestive Health, National Clinical Research Center for Digestive Disease, Beijing Key Laboratory of Early Gastrointestinal Cancer Medicine and Medical Devices, Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical UniversityDepartment of Computer Science and Engineering, University of CaliforniaState Key Laboratory of Digestive Health, National Clinical Research Center for Digestive Disease, Beijing Key Laboratory of Early Gastrointestinal Cancer Medicine and Medical Devices, Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical UniversityState Key Laboratory of Digestive Health, National Clinical Research Center for Digestive Disease, Beijing Key Laboratory of Early Gastrointestinal Cancer Medicine and Medical Devices, Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical UniversityAbstract Background Esophageal diseases (ED) are a common category of upper gastrointestinal disorders, mainly including gastroesophageal reflux disease (GERD), esophagitis, Barrett’s esophagus, achalasia, and esophageal cancer (EC). In recent years, the high recurrence rate of GERD and poor prognosis of EC are paid more attention, collectively contributing to the global burden of ED. Methods For this study, we systematically analyzed the global distribution of ED from 1990 to 2021, detailing the burden across different countries, regions, and socio-demographic index (SDI) levels. Furthermore, we explored temporal trends in ED burden over this period and conducted decomposition analysis, health inequality analysis, and frontier analysis. Finally, we projected trends in ED burden from 2022 to 2045, and quantify contributions of associated risk factors to disability-adjusted life years (DALYs) of EC. Results The absolute numbers of incidence, mortality, and DALYs for GERD and EC showed increasing trends from 1990 to 2021, while their age-standardized rates (ASRs) demonstrated divergent patterns: stable for GERD and declining for EC. The highest ASRs were observed in low-middle SDI regions for GERD and high-middle SDI regions for EC, respectively, with population as a main driver. If current trends continue, the burden of GERD will continue to rise, whereas that of EC will persistently decline by 2045. In 2021, DALYs of EC were mainly attributed to smoking (36.5%) and alcohol use (16.2%). Conclusions For GERD and EC, the global burden continued to rise and decline from 1990 to 2021, respectively. Developing targeted public health strategies in different countries and regions is crucial for alleviating the global burden of ED.https://doi.org/10.1186/s12876-025-03988-8Gastroesophageal reflux diseaseEsophageal cancerGlobal burden of diseasesIncidenceMortalityDisability-adjusted life years
spellingShingle Yanbin Wei
Endian Liu
Jiafei Peng
Yanqing Liu
Xiujing Sun
Xin Yao
Global burden of esophageal diseases: a comprehensive analysis of disease trends and risk factors from 1990 to 2021
BMC Gastroenterology
Gastroesophageal reflux disease
Esophageal cancer
Global burden of diseases
Incidence
Mortality
Disability-adjusted life years
title Global burden of esophageal diseases: a comprehensive analysis of disease trends and risk factors from 1990 to 2021
title_full Global burden of esophageal diseases: a comprehensive analysis of disease trends and risk factors from 1990 to 2021
title_fullStr Global burden of esophageal diseases: a comprehensive analysis of disease trends and risk factors from 1990 to 2021
title_full_unstemmed Global burden of esophageal diseases: a comprehensive analysis of disease trends and risk factors from 1990 to 2021
title_short Global burden of esophageal diseases: a comprehensive analysis of disease trends and risk factors from 1990 to 2021
title_sort global burden of esophageal diseases a comprehensive analysis of disease trends and risk factors from 1990 to 2021
topic Gastroesophageal reflux disease
Esophageal cancer
Global burden of diseases
Incidence
Mortality
Disability-adjusted life years
url https://doi.org/10.1186/s12876-025-03988-8
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