Disease burden and trend of esophageal cancer in China from 2001 to 2021_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Qian ¹ , LIU Na ¹ , DING Ziyuan ² , MA Jianfeng ³ , WANG Yongfeng ³ ,  LI Sheng ⁴

1. School of Public Health of Lanzhou University, Lanzhou 730000, P. R. China;
2. The Second Clinical Medical College of Lanzhou University, Lanzhou 730000, P. R. China;
3. The First Clinical Medical College of Lanzhou University, Lanzhou 730000, P. R. China;
4. The First People’s Hospital of Lanzhou, Lanzhou 730000, P. R. China;

Corresponding?author：

LI Sheng, Email: doctorlisheng@163.com

Keywords：

Esophageal cancer; Disease burden; China; Joinpoint regression model

DOI：

10.7507/1672-2531.202503169

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the spatiotemporal evolution characteristics of the disease burden of esophageal cancer in China from 2001 to 2021, and provide scientific evidence for optimizing public health intervention strategies. Methods Data were derived from the Global Burden of Diseases (GBD 2021) database, extracting indicators including incidence, prevalence, mortality, disability-adjusted life year (DALY) rate, and years of life lost (YLL) rate for esophageal cancer in China. The Joinpoint regression model was employed to assess long-term trends in disease burden across genders and age groups, combined with age-standardization using the GBD world standard population. Average annual percentage change (AAPC) and 95% confidence intervals (CI) were calculated, and Excel 2019 was used for data collation and descriptive statistics. Results In 2021, the crude incidence, prevalence, and mortality rates of esophageal cancer in China were 22.55, 38.37, and 20.26 per 100 000 population, respectively, representing increases of 13.49%, 23.41%, and 1.30% compared to 2001. The DALY and YLL rates were 450.14 and 436.29 per 100 000, decreasing by 18.01% and 16.10% over the same period. Significant gender disparities were observed, with males exhibiting higher age-standardized incidence, prevalence, mortality, DALY, and YLL rates than females. In 2021, the male age-standardized incidence (34.29/100 000) and mortality (31.06/100 000) rates were 3.3 and 3.5 times those of females, respectively. Disease burden increased exponentially with age, peaking in the 70 to 74-year-old group for incidence, prevalence, and DALY rates, with males showing significantly higher values than females. Trend analysis of standardized rates revealed significant declines from 2001 to 2021, with AAPC values of ?2.03% for incidence, ?1.42% for prevalence, ?2.57% for mortality, and ?2.84% for DALY rate (all P<0.05). Conclusion The age-standardized disease burden of esophageal cancer in China has decreased over the past two decades, while crude rates have continued to rise, with a pronounced burden among males and older populations. Against the backdrop of accelerating population aging, targeted early screening, behavioral interventions, and optimized resource allocation are imperative to address the challenges in preventing and controlling esophageal cancer.

Citation： LIU Qian, LIU Na, DING Ziyuan, MA Jianfeng, WANG Yongfeng, LI Sheng. Disease burden and trend of esophageal cancer in China from 2001 to 2021. Chinese Journal of Evidence-Based Medicine, 2025, 25(9): 1012-1019. doi: 10.7507/1672-2531.202503169 Copy

1.	Teng Y, Xia C, Cao M, et al. Esophageal cancer global burden profiles, trends, and contributors. Cancer Biol Med, 2024, 21(8): 656-666.
2.	孟娜, 俞浩, 羅鵬飛, 等. 1990-2019年江蘇省居民食管癌疾病負擔及其危險因素變化趨勢分析. 中國腫瘤, 2023, 32(3): 184-190.
3.	滕熠, 曹毛毛, 嚴鑫鑫, 等. 1990-2019年早發食管癌疾病負擔及變化趨勢: 中國與全球對比分析. 中華腫瘤防治雜志, 2024, 31(4): 189-195.
4.	Yang S, Lin S, Li N, et al. Burden, trends, and risk factors of esophageal cancer in China from 1990 to 2017: an up-to-date overview and comparison with those in Japan and South Korea. J Hematol Oncol, 2020, 13(1): 146.
5.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
6.	赫捷, 陳萬青, 李兆申, 等. 中國食管癌篩查與早診早治指南(2022, 北京). 中華消化外科雜志, 2022, 21(6): 677-709.
7.	中華人民共和國國家衛生健康委員會醫政醫管局. 食管癌診療指南(2022年版). 中華消化外科雜志, 2022, 21(10): 1247-1268.
8.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
9.	陳旭宏, 李夢蝶, 袁依, 等. 1990-2019年中國非酒精性脂肪肝炎導致的肝癌疾病負擔變化分析. 公共衛生與預防醫學, 2023, 34(5): 25-29.
10.	劉永鵬, 張晶晶, 任艷, 等. 1990-2019年中國胰腺癌疾病負擔變化趨勢研究. 現代預防醫學, 2022, 49(17): 3079-3085, 3110.
11.	汪哲, 包云麗, 李娜, 等. 1990-2019年中國胃癌疾病負擔及變化趨勢分析. 現代預防醫學, 2023, 50(12): 2128-2131, 2164.
12.	李輝章, 杜靈彬. Joinpoint回歸模型在腫瘤流行病學時間趨勢分析中的應用. 中華預防醫學雜志, 2020, 54(8): 908-912.
13.	劉珊山, 于曉輝, 秦建偉. 1990-2019年中國肝硬化疾病負擔變化趨勢分析. 臨床肝膽病雜志, 2024, 40(4): 726-733.
14.	陳重陽, 潘斌晶, 閆俊新, 等. 2型糖尿病患者中ZJU指數定義的非酒精性脂肪性肝病與血清25-羥維生素D水平的關系. 海軍軍醫大學學報, 2023, 44(2): 197-204.
15.	陳飛, 王悠清. 1990-2019年中國食管癌疾病負擔及其變化趨勢分析. 中國腫瘤, 2021, 30(6): 401-407.
16.	楊之詢, 陳萬青. 癌癥負擔預測方法學的研究進展. 中國腫瘤, 2019, 28(4): 241-245.
17.	Yang ZX, Chen WO. Progress of research on the methodology of prediction of cancer burden. China Cancer, 2019, 28(4): 241-245.
18.	李國仁, 戴建華. 我國食管癌治療理念與模式的沿革和進展. 中華胸部外科電子雜志, 2023, 10(2): 117-125.
19.	劉愛玲, 周靜靜, 李成程, 等. 1990-2019年中國歸因于煙草的食管癌疾病負擔趨勢和死亡預測分析. 中國全科醫學, 2023, 26(36): 4587-4594, 4601.
20.	徐玥, 廖應英, 孫澤群. 食管癌的流行病學特征及發病高危因素研究進展. 中國現代醫生, 2024, 62(7): 113-117.
21.	雷淑林, 楊麗平, 李艷艷. 2016-2020年空軍軍醫大學第一附屬醫院西京醫院胃鏡檢查確診食管癌流行病學特征及變化趨勢. 河北醫科大學學報, 2022, 43(2): 150-154.
22.	鄭淵杰, 滕熠, 何思怡, 等. 2022年全球及中國食管癌流行病學特征. 中國腫瘤, 2025, 34(3): 165-170.
23.	Yan H, Huang J, Li Y, et al. Sex disparities revealed by single-cell and bulk sequencing and their impacts on the efficacy of immunotherapy in esophageal cancer. Biol Sex Differ, 2024, 15(1): 22.
24.	Wang J, Ye C, Zhang C, et al. Sex differences in cancer-specific survival for locally advanced esophageal cancer after neoadjuvant chemoradiotherapy: a population-based analysis. Front Surg, 2022, 9: 989204.
25.	羅靜, 陳國平, 祝鑫海, 等. 老年性食管癌術后淋巴結轉移的相關因素分析. 浙江臨床醫學, 2017, 19(6): 1092-1093.
26.	高楷博, 田中景. 人口老齡化對中國制造業技術轉型的影響及機制研究. 海南師范大學學報(社會科學版), 2025, 38(1): 105-112.
27.	王苗, 霍俊鋒, 孔軍輝. 2002-2014年中國惡性腫瘤死亡城鄉差異分析. 實用預防醫學, 2018, 25(11): 1302-1306.
28.	陸維權, 陳俊玲, 李文杰, 等. 食管癌高低發區居民飲用水“三氮”含量分析. 中國腫瘤, 2000, (5): 227.
29.	鄭俏俏, 吳思雅, 張寧, 等. 中國上消化道癌高危人群內鏡篩查依從率的Meta分析. 腫瘤學雜志, 2025.
30.	Mulisa G, Abebe T, Gutema B, et al. Exploring oesophageal cancer in Ethiopia: elevated incidence in females and younger cases. Cancer Rep (Hoboken), 2024, 7(12): e70048.
31.	趙惠, 陳建華. 食管鱗癌患者的基因變異及臨床關聯分析. 腫瘤, 2020, 40(6): 409-420.
32.	王海翼, 劉建霞, 馮妍舟. 改進UNet++的食道癌腫瘤分割方法. 電子設計工程, 2024, 32(3): 59-64.

1. Teng Y, Xia C, Cao M, et al. Esophageal cancer global burden profiles, trends, and contributors. Cancer Biol Med, 2024, 21(8): 656-666.
2. 孟娜, 俞浩, 羅鵬飛, 等. 1990-2019年江蘇省居民食管癌疾病負擔及其危險因素變化趨勢分析. 中國腫瘤, 2023, 32(3): 184-190.
3. 滕熠, 曹毛毛, 嚴鑫鑫, 等. 1990-2019年早發食管癌疾病負擔及變化趨勢: 中國與全球對比分析. 中華腫瘤防治雜志, 2024, 31(4): 189-195.
4. Yang S, Lin S, Li N, et al. Burden, trends, and risk factors of esophageal cancer in China from 1990 to 2017: an up-to-date overview and comparison with those in Japan and South Korea. J Hematol Oncol, 2020, 13(1): 146.
5. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
6. 赫捷, 陳萬青, 李兆申, 等. 中國食管癌篩查與早診早治指南(2022, 北京). 中華消化外科雜志, 2022, 21(6): 677-709.
7. 中華人民共和國國家衛生健康委員會醫政醫管局. 食管癌診療指南(2022年版). 中華消化外科雜志, 2022, 21(10): 1247-1268.
8. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
9. 陳旭宏, 李夢蝶, 袁依, 等. 1990-2019年中國非酒精性脂肪肝炎導致的肝癌疾病負擔變化分析. 公共衛生與預防醫學, 2023, 34(5): 25-29.
10. 劉永鵬, 張晶晶, 任艷, 等. 1990-2019年中國胰腺癌疾病負擔變化趨勢研究. 現代預防醫學, 2022, 49(17): 3079-3085, 3110.
11. 汪哲, 包云麗, 李娜, 等. 1990-2019年中國胃癌疾病負擔及變化趨勢分析. 現代預防醫學, 2023, 50(12): 2128-2131, 2164.
12. 李輝章, 杜靈彬. Joinpoint回歸模型在腫瘤流行病學時間趨勢分析中的應用. 中華預防醫學雜志, 2020, 54(8): 908-912.
13. 劉珊山, 于曉輝, 秦建偉. 1990-2019年中國肝硬化疾病負擔變化趨勢分析. 臨床肝膽病雜志, 2024, 40(4): 726-733.
14. 陳重陽, 潘斌晶, 閆俊新, 等. 2型糖尿病患者中ZJU指數定義的非酒精性脂肪性肝病與血清25-羥維生素D水平的關系. 海軍軍醫大學學報, 2023, 44(2): 197-204.
15. 陳飛, 王悠清. 1990-2019年中國食管癌疾病負擔及其變化趨勢分析. 中國腫瘤, 2021, 30(6): 401-407.
16. 楊之詢, 陳萬青. 癌癥負擔預測方法學的研究進展. 中國腫瘤, 2019, 28(4): 241-245.
17. Yang ZX, Chen WO. Progress of research on the methodology of prediction of cancer burden. China Cancer, 2019, 28(4): 241-245.
18. 李國仁, 戴建華. 我國食管癌治療理念與模式的沿革和進展. 中華胸部外科電子雜志, 2023, 10(2): 117-125.
19. 劉愛玲, 周靜靜, 李成程, 等. 1990-2019年中國歸因于煙草的食管癌疾病負擔趨勢和死亡預測分析. 中國全科醫學, 2023, 26(36): 4587-4594, 4601.
20. 徐玥, 廖應英, 孫澤群. 食管癌的流行病學特征及發病高危因素研究進展. 中國現代醫生, 2024, 62(7): 113-117.
21. 雷淑林, 楊麗平, 李艷艷. 2016-2020年空軍軍醫大學第一附屬醫院西京醫院胃鏡檢查確診食管癌流行病學特征及變化趨勢. 河北醫科大學學報, 2022, 43(2): 150-154.
22. 鄭淵杰, 滕熠, 何思怡, 等. 2022年全球及中國食管癌流行病學特征. 中國腫瘤, 2025, 34(3): 165-170.
23. Yan H, Huang J, Li Y, et al. Sex disparities revealed by single-cell and bulk sequencing and their impacts on the efficacy of immunotherapy in esophageal cancer. Biol Sex Differ, 2024, 15(1): 22.
24. Wang J, Ye C, Zhang C, et al. Sex differences in cancer-specific survival for locally advanced esophageal cancer after neoadjuvant chemoradiotherapy: a population-based analysis. Front Surg, 2022, 9: 989204.
25. 羅靜, 陳國平, 祝鑫海, 等. 老年性食管癌術后淋巴結轉移的相關因素分析. 浙江臨床醫學, 2017, 19(6): 1092-1093.
26. 高楷博, 田中景. 人口老齡化對中國制造業技術轉型的影響及機制研究. 海南師范大學學報(社會科學版), 2025, 38(1): 105-112.
27. 王苗, 霍俊鋒, 孔軍輝. 2002-2014年中國惡性腫瘤死亡城鄉差異分析. 實用預防醫學, 2018, 25(11): 1302-1306.
28. 陸維權, 陳俊玲, 李文杰, 等. 食管癌高低發區居民飲用水“三氮”含量分析. 中國腫瘤, 2000, (5): 227.
29. 鄭俏俏, 吳思雅, 張寧, 等. 中國上消化道癌高危人群內鏡篩查依從率的Meta分析. 腫瘤學雜志, 2025.
30. Mulisa G, Abebe T, Gutema B, et al. Exploring oesophageal cancer in Ethiopia: elevated incidence in females and younger cases. Cancer Rep (Hoboken), 2024, 7(12): e70048.
31. 趙惠, 陳建華. 食管鱗癌患者的基因變異及臨床關聯分析. 腫瘤, 2020, 40(6): 409-420.
32. 王海翼, 劉建霞, 馮妍舟. 改進UNet++的食道癌腫瘤分割方法. 電子設計工程, 2024, 32(3): 59-64.

Chinese Journal of Evidence-Based Medicine

Disease burden and trend of esophageal cancer in China from 2001 to 2021

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