Burden, trends and predictions of esophageal cancer in the top five GDP countries: a systematic analysis based on the Global Burden of Disease 2023 study.
- 1Department of Cardiothoracic Surgery, Tianjin Medical University General Hospital, Tianjin, China.
- 2Graduate College of Tianjin Medical University, Tianjin, China.
- 3Department of Traditional Chinese Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Abstract
Esophageal cancer remains a major global health burden, but comparative analyses across leading economies are limited. This study aimed to comprehensively evaluate and compare the esophageal cancer burden from 1990 to 2023 and project trends to 2050 in the top five gross domestic product (GDP) countries-China, Germany, India, Japan, and the United States-using data from the Global Burden of Disease (GBD) 2023 study. We extracted age-, sex-, and risk factor-specific data on esophageal cancer incidence, mortality, and disability-adjusted life years (DALYs) for the five countries from the GBD 2023 database. Age-standardized rates (ASRs) were calculated, and temporal trends were assessed using Joinpoint regression. Age-period-cohort (APC) modeling was employed to disentangle the independent effects of age, period, and cohort. Decomposition analysis quantified the contributions of population aging, population growth, and epidemiological changes. Bayesian age-period-cohort (BAPC) models were applied to project disease burden through 2050. China had the highest absolute burden but achieved the steepest declines. India's age-standardized incidence rates (ASIRs) more than doubled. Japan, Germany, and the USA maintained lower, stable rates. APC analysis showed an "inverted-U" age peak in China versus older peaks elsewhere. Decomposition identified epidemiological changes as the main alleviating factor in China, whereas aging and unfavorable trends drove India's rise. Smoking dominated in four countries; India was co-driven by chewing tobacco and low vegetable intake. BAPC projections foresee continued declines in China, Germany, and Japan, a surge in India, and a rebound in the USA. The esophageal cancer burden exhibits marked heterogeneity across the top five GDP countries, driven by distinct demographic transitions, risk factor profiles, and public health responses. These findings emphasize the urgent need for tailored, context-specific cancer control strategies, including strengthened tobacco and alcohol regulation, dietary improvements, and expanded screening in high-risk populations.
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BibTeX
@article{zhao2026burden,
title = {{Burden, trends and predictions of esophageal cancer in the top five GDP countries: a systematic analysis based on the Global Burden of Disease 2023 study.}},
author = {Hanqing Zhao and Zirong Wang and Dilihumaer Tuerxun and Zihao Li and Xingxin Wang and Peng Zhang},
journal = {Journal of thoracic disease},
year = {2026},
month = sep,
doi = {10.21037/jtd-2026-2274},
url = {https://europepmc.org/article/MED/42996681},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Burden, trends and predictions of esophageal cancer in the top five GDP countries: a systematic analysis based on the Global Burden of Disease 2023 study.
AU - Hanqing Zhao
AU - Zirong Wang
AU - Dilihumaer Tuerxun
AU - Zihao Li
AU - Xingxin Wang
AU - Peng Zhang
PY - 2026
DA - 2026/09/29
JO - Journal of thoracic disease
DO - 10.21037/jtd-2026-2274
UR - https://europepmc.org/article/MED/42996681
AB - Esophageal cancer remains a major global health burden, but comparative analyses across leading economies are limited. This study aimed to comprehensively evaluate and compare the esophageal cancer burden from 1990 to 2023 and project trends to 2050 in the top five gross domestic product (GDP) countries-China, Germany, India, Japan, and the United States-using data from the Global Burden of Disease (GBD) 2023 study. We extracted age-, sex-, and risk factor-specific data on esophageal cancer incidence, mortality, and disability-adjusted life years (DALYs) for the five countries from the GBD 2023 database. Age-standardized rates (ASRs) were calculated, and temporal trends were assessed using Joinpoint regression. Age-period-cohort (APC) modeling was employed to disentangle the independent effects of age, period, and cohort. Decomposition analysis quantified the contributions of population aging, population growth, and epidemiological changes. Bayesian age-period-cohort (BAPC) models were applied to project disease burden through 2050. China had the highest absolute burden but achieved the steepest declines. India's age-standardized incidence rates (ASIRs) more than doubled. Japan, Germany, and the USA maintained lower, stable rates. APC analysis showed an "inverted-U" age peak in China versus older peaks elsewhere. Decomposition identified epidemiological changes as the main alleviating factor in China, whereas aging and unfavorable trends drove India's rise. Smoking dominated in four countries; India was co-driven by chewing tobacco and low vegetable intake. BAPC projections foresee continued declines in China, Germany, and Japan, a surge in India, and a rebound in the USA. The esophageal cancer burden exhibits marked heterogeneity across the top five GDP countries, driven by distinct demographic transitions, risk factor profiles, and public health responses. These findings emphasize the urgent need for tailored, context-specific cancer control strategies, including strengthened tobacco and alcohol regulation, dietary improvements, and expanded screening in high-risk populations.
SN - 2072-1439
SN - 2077-6624
ER -