1. 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
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Fatemeh Ghasemi-kebria, Ana Laura Manda, Zhi-Jiang Zhang, Jalal Arabloo, Gholamreza Roshandel, Jonathan M. Kocarnik, Milena Ilic, Abdullah T Khoja, Goura Kishor Rath, Sergey Soshnikov, Girmay Teklay Weldesamuel, Azeem Majeed, Tsegaye Tewelde Gebrehiwot, Hai Quang Pham, Keyvan Pakshir, Feng Sha, Tone Bjørge, Antonio Biondi, Simon I. Hay, Ahmad Daryani, Isidora S. Vujcic, Chi Linh Hoang, Yousef Khader, Hamideh Salimzadeh, Priya Rathi, Charvi Jain, Irina Filip, Kevin S Ikuta, Andualem Henok, Mowafa Househ, Eduarda Fernandes, Silvano Gallus, Rufus A. Adedoyin, Akram Pourshams, Mostafa Dianatinasab, Gebreamlak Gebremedhn Gebremeskel, Yousef Veisani, Berhe Etsay Tesfay, Félix Carvalho, Catherine Bisignano, Kidanemaryam Berhe, Antonio Maria Borzì, Mesfin Wudu Kassaw, Manu Raj Mathur, Farnam Mohebi, Reza Mohammadpourhodki, Rashmi Gupta, Gebre Teklemariam Demoz, Bingyu Li, Arash Etemadi, Cristina Bosetti, Giulia Carreras, Arvin Haj-Mirzaian, Eman Abu-Gharbieh, Muktar Beshir Ahmed, Kiana Ramezanzadeh, Vahid Yazdi-Feyzabadi, Stephen S Lim, Jiregna Darega Gela, Dinh-Toi Chu, Irfan Ullah, Mohamed M. Gad, Eugenio Traini, Sun Ha Jee, Seyed Sina Naghibi Irvani, Ahmad Ghashghaee, Mohammad Hassan Emamian, Hassan Abolhassani, Mario Šekerija, Gurudatta Naik, Alireza Rafiei, Huong Lan Thi Nguyen, Sadaf G. Sepanlou, Florian Fischer, Mona Pathak, Krittika Bhattacharyya, Clara Castro, Elias Merdassa Roro, Andrew T Olagunju, Salman Rawaf, Rahmatollah Moradzadeh, Amir Kasaeian, Sara Sheikhbahaei, Anas M. Saad, Mohammad Rabiee, Vahid Alipour, Varshil Mehta, Molly R Nixon, Vera Marisa Costa, Christina Fitzmaurice, Mohsen Naghavi, Ghobad Moradi, Benn Sartorius, Sudeep K Siddappa Malleshappa, Ali Kabir, Saeid Safiri, Deniz Yuce, Abdallah M. Samy, Lorenzo Monasta, Hamid Yimam Hassen, Alaa Badawi, Vesna Zadnik, Abadi Kahsu Gebre, Savita Lasrado, Atalel Fentahun Awedew, Walter Mendoza, Abdulaziz M. Almulhim, Rajan Nikbakhsh, Iffat Elbarazi, Dhirendra N Sinha, Fares Alahdab, Morteza Arab-Zozani, Ali H. Mokdad, Tomi Akinyemiju, Kathleen S Sachiko Berfield, H. Dean Hosgood, Rixing Xu, James D. Harvey, Carlo La Vecchia, Nermin Ghith, Vivek Kumar, Mahaveer Golechha, Mahmood Moosazadeh, Farhad Islami, Catalin-Gabriel Smarandache, Ejaz Ahmad Khan, Reza Malekzadeh, Tinuke O Olagunju, Arash Sarveazad, Pawan Faris, Farhad Moradpour, Jasvinder A. Singh, Dariush Nasrollahzadeh, Dhruv Mehta, Nima Rezaei, Haruna Asura Nggada, Feleke Mekonnen Demeke, Spencer L. James, Amir Radfar, Supreet Kaur, Farahnaz Joukar, Ravi Prakash Jha, Bhaskar Thakur, Ionut Negoi, Olayinka Stephen Ilesanmi, Shailesh Advani, Begashaw Melaku Gebresillassie, Prasanna Mithra, Maryam Hashemian, Jagadish Rao Padubidri, Navid Rabiee, Shanti Patel, Amir Almasi-Hashiani, Alireza Ansari-Moghaddam, Alan D. Lopez, Rovshan Khalilov, Farin Kamangar, Nima Hafezi-Nejad, Khanh Bao Tran, Esma Kerboua, Navid Manafi, Andre Pascal Kengne, Giuseppe Gorini, Fariborz Mansour-Ghanaei, Bach Xuan Tran, Chisom Joyqueenet Akunna, Abdollah Mohammadian-Hafshejani, Degena Bahrey Tadesse, Miloud Taki Eddine Aichour, Baye Dagnew, David Laith Rawaf, Zoubida Zaidi, Hafiz Ansar Rasul Suleria, Karzan Abdulmuhsin Mohammad, Morteza Shamsizadeh, Jemal Abdu Mohammed, Nahla Anber, Marco Vacante, Delaram Moosavi, Hamidreza Komaki, Reza Shirkoohi, and GBD 2017 Oesophageal Canc Coll
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Adult ,Male ,Adolescent ,Alcohol Drinking ,Esophageal Neoplasms ,Population ,Adenocarcinoma ,Article ,Global Burden of Disease ,03 medical and health sciences ,Tobacco Use ,Young Adult ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Risk Factors ,Medicine ,Humans ,education ,Cause of death ,Aged ,Aged, 80 and over ,education.field_of_study ,Hepatology ,business.industry ,Mortality rate ,Incidence (epidemiology) ,Gastroenterology ,Cancer ,Middle Aged ,Overweight ,medicine.disease ,oesophageal cancer, GBD, risk factors ,Verbal autopsy ,Diet ,Chewing tobacco ,030220 oncology & carcinogenesis ,Air Pollution, Indoor ,Attributable risk ,Carcinoma, Squamous Cell ,Gastroesophageal Reflux ,030211 gastroenterology & hepatology ,Female ,GBD 2017 Oesophageal Cancer Collaborators ,Human medicine ,Quality-Adjusted Life Years ,business ,Demography - Abstract
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 age-standardised 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. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.
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- 2019
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