Yang Si, Lin Shuai, Li Na, Deng Yujiao, Wang Meng, Xiang Dong, Xiang Grace, Wang Shuqian, Ye Xianghua, Zheng Yi, Yao Jia, Zhai Zhen, Wu Ying, Hu Jingjing, Kang Huafeng, Dai Zhijun
Department of Breast Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, Zhejiang, China.
Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China.
J Hematol Oncol. 2020 Nov 2;13(1):146. doi: 10.1186/s13045-020-00981-4.
The epidemiology of esophageal cancer (EC) can elucidate its causes and risk factors and help develop prevention strategies. We aimed to provide an overview of the burden, trends, and risk factors of EC in China from 1990 to 2017. We also investigated the differences between China, Japan, and South Korea and discussed the possible causes of the disparities.
We used the Global Burden of Disease Study 2017 to obtain data on incident cases, deaths, disability-adjusted life-year (DALY) cases, age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and age-standardized DALY rate of EC in China, Japan, and South Korea from 1990 to 2017. Trend analysis was performed using joinpoint analysis. We measured the associations between ASIR, ASDR, and age-standardized DALY rate and the socio-demographic index (SDI) for 1990-2017. We also analyzed the risk factors associated with EC deaths and DALYs.
China recorded 234,624 (95% uncertainty intervals: 223,240-246,036) incident cases of and 212,586 (202,673-222,654) deaths from EC in 2017. The ASIR and ASDR declined from 1990 to 2017. Until 2017, the ASIR was 12.23, and ASDR was 11.25 per 100,000 persons. The DALYs were 4,464,980 (4,247,816-4,690,846) with an age-standardized rate of 222.58 per 100,000 persons in 2017. The ASIR, ASDR, and age-standardized DALY rate in China were twice those of Japan and South Korea. These three indicators showed a decreasing trend, whereas SDI increased, in all three countries from 1990 to 2017. Tobacco and alcohol use remained the major risk factors for EC death and DALYs, especially for men in China and women in Japan and South Korea. High body mass index (BMI) and low-fruit diet were the main risk factors for women in China.
The incident cases and deaths of EC in China, Japan, and South Korea increased from 1990 to 2017, whereas the ASIR, ASDR, and age-standardized DALY rate declined. China had the greatest burden of EC among three countries. SDI and aging along with tobacco use, alcohol use, high BMI, and low-fruit diet were the main risk factors of death and DALYs and should be paid more attention.
食管癌（EC）的流行病学可阐明其病因和风险因素，并有助于制定预防策略。我们旨在概述1990年至2017年中国食管癌的负担、趋势和风险因素。我们还研究了中国、日本和韩国之间的差异，并讨论了差异的可能原因。
我们使用《2017年全球疾病负担研究》获取1990年至2017年中国、日本和韩国食管癌的发病病例、死亡病例、伤残调整生命年（DALY）病例、年龄标准化发病率（ASIR）、年龄标准化死亡率（ASDR）和年龄标准化DALY率的数据。使用Joinpoint分析进行趋势分析。我们测量了1990 - 2017年ASIR、ASDR和年龄标准化DALY率与社会人口指数（SDI）之间的关联。我们还分析了与食管癌死亡和DALYs相关的风险因素。
2017年中国记录了234,624例（95%不确定区间：223,240 - 246,036）食管癌发病病例和212,586例（202,673 - 222,654）死亡病例。1990年至2017年ASIR和ASDR有所下降。截至2017年，ASIR为每10万人12.23例，ASDR为每10万人11.25例。2017年DALYs为4,464,980例（4,247,816 - 4,690,846），年龄标准化率为每10万人222.58例。中国的ASIR、ASDR和年龄标准化DALY率是日本和韩国的两倍。从1990年到2017年，这三个国家的这三个指标呈下降趋势，而SDI呈上升趋势。烟草和酒精使用仍然是食管癌死亡和DALYs的主要风险因素，特别是在中国的男性以及日本和韩国的女性中。高体重指数（BMI）和低水果饮食是中国女性的主要风险因素。
1990年至2017年中国、日本和韩国的食管癌发病病例和死亡病例有所增加，而ASIR、ASDR和年龄标准化DALY率有所下降。中国在这三个国家中食管癌负担最重。SDI、老龄化以及烟草使用、酒精使用、高BMI和低水果饮食是死亡和DALYs的主要风险因素，应予以更多关注。
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