Trends in the disease burden of esophageal cancer attributable to alcohol consumption in China from 1990 to 2019 and a gender comparison analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HU Shoucai ^1,2,3 , YANG Chenglong ^1,2,3 , MA Haotian ^1,2,3 , TAO Yancheng ^1,2,3 ,  HU Gawei ^1,2 ,  LI Qingxin ^1,2

1. Department of Thoracic Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army, Lanzhou, 730000, P. R. China;
2. Highland Medicine Department, The 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army, Lanzhou, 730050, P. R. China;
3. The First Clinical Department of Gansu University of Traditional Chinese Medicine, Lanzhou, 730000, P. R. China;

Corresponding?author：

HU Gawei, Email: 371694464@qq.com; LI Qingxin, Email: liqxchest@163.com

Keywords：

Alcohol consumption; esophageal cancer; disease burden; change trend; Joinpoint model

DOI：

10.7507/1007-4848.202405053

Video：

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Objective To integrate and analyze the disease burden of esophageal cancer caused by alcohol consumption in China from 1990 to 2019, along with the differences between genders, and predict the trends in disease burden changes from 2020 to 2029 to improve prevention and treatment strategies. Methods The disease burden of esophageal cancer caused by alcohol consumption in China from 1990 to 2019 was extracted and integrated from the 2019 Global Burden of Disease (GBD) database, and the corresponding trend was analyzed using the Joinpoint regression model with Joinpoint 4.9.1.0 software. The gray prediction model [GM (1, 1) ] was used to forecast the disease burden of alcohol-related esophageal cancer in China from 2020 to 2029. Results In 2019, the leading causes of esophageal cancer in China were tobacco, alcohol, high body mass index, and insufficient fruit and vegetable intake, accounting for the first to fifth positions in esophageal cancer deaths. From a gender perspective, in 2019, the death number and standardized mortality rate for males were 18.97 times and 20.00 times higher than for females, respectively. The disability-adjusted life years (DALYs) and standardized DALYs rate for males were 33.08 times and 24.78 times higher than those for females, respectively, indicating a heavier disease burden of alcohol-related esophageal cancer among Chinese males. From 1990 to 2019, the average annual percentage change (AAPC) in deaths and DALYs due to alcohol-related esophageal cancer in China was 2.08% and 1.63%, respectively, showing a continuous upward trend with statistical significance (P<0.05). The AAPC values for standardized mortality rate and standardized DALYs rate from 1990 to 2019 were –0.92% and –1.23%, respectively, showing a continuous downward trend with statistical significance (P<0.05). The population aged ≥55 years was the main group bearing the disease burden among all age groups from 1990 to 2019. The gray prediction model predicted that by 2029, the overall standardized mortality rate and standardized DALYs rate would decrease to 2.94/100 000and 67.94/100 000, with a greater decline in females than in males. Conclusion Over the past 30 years, the disease burden of alcohol-related esophageal cancer in China has slightly decreased. However, the reduction in disease burden is still lower compared to the overall decline in esophageal cancer burden, and the disease burden for males is significantly higher than for females. Focusing on prevention and treatment for males and the elderly population remains a major issue in addressing alcohol-related esophageal cancer in China.

Citation： HU Shoucai, YANG Chenglong, MA Haotian, TAO Yancheng, HU Gawei, LI Qingxin. Trends in the disease burden of esophageal cancer attributable to alcohol consumption in China from 1990 to 2019 and a gender comparison analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2025, 32(4): 500-507. doi: 10.7507/1007-4848.202405053 Copy

1.	張嘉誠, 高雅, 孔德九, 等. 循環microRNAs作為潛在食管癌標志物診斷價值的Meta分析. 食管疾病, 2023, 5(4): 255-259.Zhang JC, Gao Y, Kong DJ, et al. Meta analysis of diagnostic value of circulating microRNAs as potential biomarkers for esophageal cancer. J Esophageal Dis, 2023, 5(4): 255-259.
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9.	張敏, 徐杰茹, 陳磊, 等. 基于GBD數據分析1990—2019年中國胰腺癌發病趨勢. 現代預防醫學, 2022, 49(7): 1159-1164.Zhang M, Xu JR, Chen L, et al. Analysis of the incidence trend of pancreatic cancer in China from 1990 to 2019 based on GBD data. Mod Prev Med, 2022, 49(7): 1159-1164.
10.	Rehman S, Rehman E, Ikram M, et al. Cardiovascular disease (CVD): Assessment, prediction and policy implications. BMC Public Health, 2021, 21(1): 1299.
11.	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.Liu AL, Zhou JJ, Li CC, et al. Analysis of the disease burden trends and death projections for esophageal cancer attributable to tobacco in China from 1990 to 2019. Chin Gen Pract, 2023, 26(36): 4587-4594, 4601.
12.	王紅心, 樊文龍, 楊曉雨, 等. 1990—2019年中國蛋白質能量營養不良發病趨勢及預測研究. 中國全科醫學, 2023, 26(5): 591-597.Wang HX, Fan WL, Yang XY, et al. Protein-energy malnutrition incidence in China: Trend in 1990-2019 and future trend in 2020-2029. Chin Gen Pract, 2023, 26(5): 591-597.
13.	胡守財, 陶堰成, 馬浩天, 等. 1990~2019年中國非風濕性瓣膜性心臟病疾病負擔及變化趨勢分析. 中國循環雜志, 2024, 39(8): 806-812.Hu SC, Tao YC, Ma HT, et al. Disease burden and changing trend of non-rheumatic valvular heart disease from 1990 to 2019 in China. Chin Circ J, 2024, 39(8): 806-812.
14.	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.Chen F, Wang YQ. Disease burden and trends of esophageal cancer in China during 1990-2019. China Cancer, 2021, 30(6): 401-407.
15.	Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
16.	Frick C, Rumgay H, Vignat J, et al. Quantitative estimates of preventable and treatable deaths from 36 cancers worldwide: A population-based study. Lancet Glob Health, 2023, 11(11): e1700-e1712.
17.	Catelan D, Biggeri A, Bucchi L, et al. Epidemiologic transition of lung cancer mortality in Italy by sex, province of residence and birth cohort (1920-1929 to 1960-1969). Int J Cancer, 2023, 153(10): 1746-1757.
18.	Ran X, Zeng H, Zheng R, et al. Geographic, sex and socioeconomic disparities in esophageal cancer incidence in China: A population-based study. Int J Cancer, 2024, 154(3): 477-487.
19.	DesJardin JT, Chikwe J, Hahn RT, et al. Sex differences and similarities in valvular heart disease. Circ Res, 2022, 130(4): 455-473.
20.	Jin EH, Han K, Shin CM, et al. Sex and tumor-site differences in the association of alcohol intake with the risk of early-onset colorectal cancer. J Clin Oncol, 2023, 41(22): 3816-3825.
21.	Li S, Chen H, Man J, et al. Changing trends in the disease burden of esophageal cancer in China from 1990 to 2017 and its predicted level in 25 years. Cancer Med, 2021, 10(5): 1889-1899.
22.	Song F, Liu FZ, Liang YF, et al. Clinical, sonographic characteristics and long-term prognosis of valvular heart disease in elderly patients. J Geriatr Cardiol, 2019, 16(1): 33-41.
23.	Yu G, Gong X, Xu Y, et al. The global burden and trends of four major types of heart disease, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019. Public Health, 2023, 220: 1-9.
24.	Zheng X, Guan Q, Lin X. Changing trends of the disease burden of non-rheumatic valvular heart disease in China from 1990 to 2019 and its predictions: Findings from global burden of disease study. Front Cardiovasc Med, 2023, 9: 912661.

1. 張嘉誠, 高雅, 孔德九, 等. 循環microRNAs作為潛在食管癌標志物診斷價值的Meta分析. 食管疾病, 2023, 5(4): 255-259.Zhang JC, Gao Y, Kong DJ, et al. Meta analysis of diagnostic value of circulating microRNAs as potential biomarkers for esophageal cancer. J Esophageal Dis, 2023, 5(4): 255-259.
2. 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.
3. 劉宗超, 李哲軒, 張陽, 等. 2020全球癌癥統計報告解讀. 腫瘤綜合治療電子雜志, 2021, 7(2): 1-14.Liu ZC, Li ZX, Zhang Y, et al. Interpretation on the report of Global Cancer Statistics 2020. J Multidiscip Cancer Manag (Electron Ed), 2021, 7(2): 1-14.
4. GBD 2017 Oesophageal Cancer Collaborators. 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. Lancet Gastroenterol Hepatol, 2020, 5(6): 582-597.
5. GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet, 2018, 392(10152): 1015-35.
6. GBD 2017 Risk Factor Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2018, 392(10159): 1923-94.
7. Millwood IY, Im PK, Bennett D, et al. Alcohol intake and cause-specific mortality: Conventional and genetic evidence in a prospective cohort study of 512 000 adults in China. Lancet Public Health, 2023, 8(12): e956-e967.
8. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990—2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet, 2020, 396(10258): 1204-1222.
9. 張敏, 徐杰茹, 陳磊, 等. 基于GBD數據分析1990—2019年中國胰腺癌發病趨勢. 現代預防醫學, 2022, 49(7): 1159-1164.Zhang M, Xu JR, Chen L, et al. Analysis of the incidence trend of pancreatic cancer in China from 1990 to 2019 based on GBD data. Mod Prev Med, 2022, 49(7): 1159-1164.
10. Rehman S, Rehman E, Ikram M, et al. Cardiovascular disease (CVD): Assessment, prediction and policy implications. BMC Public Health, 2021, 21(1): 1299.
11. 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.Liu AL, Zhou JJ, Li CC, et al. Analysis of the disease burden trends and death projections for esophageal cancer attributable to tobacco in China from 1990 to 2019. Chin Gen Pract, 2023, 26(36): 4587-4594, 4601.
12. 王紅心, 樊文龍, 楊曉雨, 等. 1990—2019年中國蛋白質能量營養不良發病趨勢及預測研究. 中國全科醫學, 2023, 26(5): 591-597.Wang HX, Fan WL, Yang XY, et al. Protein-energy malnutrition incidence in China: Trend in 1990-2019 and future trend in 2020-2029. Chin Gen Pract, 2023, 26(5): 591-597.
13. 胡守財, 陶堰成, 馬浩天, 等. 1990~2019年中國非風濕性瓣膜性心臟病疾病負擔及變化趨勢分析. 中國循環雜志, 2024, 39(8): 806-812.Hu SC, Tao YC, Ma HT, et al. Disease burden and changing trend of non-rheumatic valvular heart disease from 1990 to 2019 in China. Chin Circ J, 2024, 39(8): 806-812.
14. 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.Chen F, Wang YQ. Disease burden and trends of esophageal cancer in China during 1990-2019. China Cancer, 2021, 30(6): 401-407.
15. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
16. Frick C, Rumgay H, Vignat J, et al. Quantitative estimates of preventable and treatable deaths from 36 cancers worldwide: A population-based study. Lancet Glob Health, 2023, 11(11): e1700-e1712.
17. Catelan D, Biggeri A, Bucchi L, et al. Epidemiologic transition of lung cancer mortality in Italy by sex, province of residence and birth cohort (1920-1929 to 1960-1969). Int J Cancer, 2023, 153(10): 1746-1757.
18. Ran X, Zeng H, Zheng R, et al. Geographic, sex and socioeconomic disparities in esophageal cancer incidence in China: A population-based study. Int J Cancer, 2024, 154(3): 477-487.
19. DesJardin JT, Chikwe J, Hahn RT, et al. Sex differences and similarities in valvular heart disease. Circ Res, 2022, 130(4): 455-473.
20. Jin EH, Han K, Shin CM, et al. Sex and tumor-site differences in the association of alcohol intake with the risk of early-onset colorectal cancer. J Clin Oncol, 2023, 41(22): 3816-3825.
21. Li S, Chen H, Man J, et al. Changing trends in the disease burden of esophageal cancer in China from 1990 to 2017 and its predicted level in 25 years. Cancer Med, 2021, 10(5): 1889-1899.
22. Song F, Liu FZ, Liang YF, et al. Clinical, sonographic characteristics and long-term prognosis of valvular heart disease in elderly patients. J Geriatr Cardiol, 2019, 16(1): 33-41.
23. Yu G, Gong X, Xu Y, et al. The global burden and trends of four major types of heart disease, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019. Public Health, 2023, 220: 1-9.
24. Zheng X, Guan Q, Lin X. Changing trends of the disease burden of non-rheumatic valvular heart disease in China from 1990 to 2019 and its predictions: Findings from global burden of disease study. Front Cardiovasc Med, 2023, 9: 912661.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Trends in the disease burden of esophageal cancer attributable to alcohol consumption in China from 1990 to 2019 and a gender comparison analysis

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