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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 Publisher Pubmed



Nasrollahzadeh D14 ; Safiri S15, 16 ; Sepanlou SG6, 18 ; Fitzmaurice C20, 23 ; Ikuta KS22, 23 ; Bisignano C23 ; Islami F24 ; Roshandel G6, 25 ; Abolhassani H12, 26 ; Abugharbieh E27 ; Advani SM29, 30 ; Ahmed MB31, 32 ; Aichour MTE33 ; Akinyemiju T34, 35 Show All Authors
Authors
  1. Nasrollahzadeh D14
  2. Safiri S15, 16
  3. Sepanlou SG6, 18
  4. Fitzmaurice C20, 23
  5. Ikuta KS22, 23
  6. Bisignano C23
  7. Islami F24
  8. Roshandel G6, 25
  9. Abolhassani H12, 26
  10. Abugharbieh E27
  11. Advani SM29, 30
  12. Ahmed MB31, 32
  13. Aichour MTE33
  14. Akinyemiju T34, 35
  15. Akunna CJ36, 37
  16. Alahdab F38
  17. Alipour V40, 41
  18. Almasihashiani A47
  19. Almulhim AM48
  20. Anber NH49
  21. Arabloo J41
  22. Arabzozani M51
  23. Awedew AF52
  24. Badawi A53, 54
  25. Berfield KSS21, 55
  26. Berhe K57
  27. Bhattacharyya K59, 60
  28. Borzi AM61
  29. Bosetti C66
  30. Carreras G68
  31. Chu DT73
  32. Costa VM71
  33. Dagnew B75
  34. Gela JD76
  35. Demeke FM81
  36. Demoz GT83, 84
  37. Dianatinasab M17, 85
  38. Elbarazi I87
  39. Emamian MH86
  40. Etemadi A88
  41. Faris PS89, 90
  42. Filip I91, 93
  43. Fischer F94
  44. Gad MM95, 97
  45. Gallus S65
  46. Gebre AK58, 98
  47. Gebrehiwot TT31
  48. Gebremeskel GG56, 82
  49. Gebresillassie BM74, 99
  50. Ghasemikebria F25
  51. Ghashghaee A41, 45
  52. Ghith N100, 101
  53. Golechha M102
  54. Gorini G67
  55. Hafezinejad N13, 107
  56. Hajmirzaian A4, 109
  57. Harvey JD23
  58. Hashemian M6, 112
  59. Hassen HY113, 114
  60. Henok A114
  61. Hoang CL115
  62. Hosgood HD116
  63. Ilesanmi OS118, 119
  64. Irvani SSN110
  65. Jain C121
  66. James SL23
  67. Jee SH122, 123
  68. Jha RP124, 125
  69. Joukar F126, 127
  70. Kabir A42
  71. Kasaeian A9, 44
  72. Kassaw MW128, 129
  73. Kaur S130
  74. Khan EA137
  75. Khoja AT105, 138
  76. Kocarnik JM23, 139
  77. Komaki H140, 141
  78. Kumar V142
  79. Lasrado S144
  80. Li B145
  81. Manafi N43, 151
  82. Manda AL152, 153
  83. Mathur MR154, 155
  84. Mehta V156
  85. Mehta D157
  86. Mendoza W158, 159
  87. Mithra P160
  88. Mohammad KA90, 163
  89. Mohammadianhafshejani A164
  90. Mohammadpourhodki R165
  91. Mohammed JA166
  92. Mohebi F10, 11
  93. Mokdad AH20, 23
  94. Monasta L167
  95. Moosavi D46
  96. Moosazadeh M78
  97. Moradi G168, 169
  98. Moradpour F169
  99. Moradzadeh R47
  100. Naik G170
  101. Negoi I153, 172
  102. Nggada HA173, 174
  103. Nguyen HLT175
  104. Nikbakhsh R108, 176
  105. Nixon MR23
  106. Olagunju AT178, 179
  107. Olagunju TO177
  108. Padubidri JR161
  109. Patel S180
  110. Pathak M181
  111. Pham HQ175
  112. Rabiee N182
  113. Radfar A92, 184
  114. Rafiei A77, 79
  115. Ramezanzadeh K111
  116. Rathi P162
  117. Rawaf DL150, 187
  118. Rezaei N12, 188
  119. Roro EM84, 189
  120. Saad AM96
  121. Salimzadeh H6
  122. Samy AM190
  123. Sarveazad A39
  124. Sekerija M192, 193
  125. Sha F194
  126. Shamsizadeh M195
  127. Sheikhbahaei S8, 106
  128. Shirkoohi R2, 3
  129. Malleshappa SKS196
  130. Sinha DN198, 199
  131. Smarandache CG153, 172
  132. Soshnikov S200, 201
  133. Suleria HAR146
  134. Tadesse DB82, 202
  135. Tesfay BE203
  136. Thakur B204
  137. Traini E205
  138. Tran KB206
  139. Tran BX207
  140. Ullah I208
  141. Vacante M209
  142. Veisani Y210
  143. Vujcic IS211
  144. Weldesamuel GT82
  145. Xu R23
  146. Yazdifeyzabadi V212, 213
  147. Yuce D214
  148. Zhang ZJ217
  149. Malekzadeh R5, 18
  150. Naghavi M20, 23
Show Affiliations
Authors Affiliations
  1. 1. Biology Department, Morgan State University, Baltimore, MD, United States
  2. 2. Cancer Biology Research Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Digestive Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Digestive Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
  10. 10. National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Iran
  11. 11. Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
  12. 12. Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
  13. 13. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  14. 14. Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
  15. 15. Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
  16. 16. Department of Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
  17. 17. Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
  18. 18. Non-communicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  19. 19. Department of Parasitology and Mycology, Shiraz University of Medical Sciences, Shiraz, Iran
  20. 20. Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, United States
  21. 21. Department of Surgery, University of Washington, Seattle, WA, United States
  22. 22. Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, United States
  23. 23. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
  24. 24. Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, United States
  25. 25. Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
  26. 26. Department of Laboratory Medicine, Karolinska University Hospital, Huddinge, Sweden
  27. 27. College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
  28. 28. Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
  29. 29. Social and Behavioral Research Branch, National Institute of Health, Bethesda, MD, United States
  30. 30. Department of Oncology, Georgetown University, Washington, DC, United States
  31. 31. Department of Epidemiology, Jimma University, Jimma, Ethiopia
  32. 32. Australian Center for Precision Health, University of South Australia, Adelaide, Australia
  33. 33. Higher National School of Veterinary Medicine, Algiers, Algeria
  34. 34. Department of Population Health Sciences, Duke University, Durham, NC, United States
  35. 35. Duke Global Health Institute, Duke University, Durham, NC, United States
  36. 36. Department of Public Health, Intercountry Centre for Oral Health (ICOH) for Africa, Jos, Nigeria
  37. 37. Department of Public Health, Federal Ministry of Health, Garki, Nigeria
  38. 38. Mayo Evidence-based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, MN, United States
  39. 39. Colorectal Research Center, Tehran, Iran
  40. 40. Health Economics Department, Tehran, Iran
  41. 41. Health Management and Economics Research Center, Tehran, Iran
  42. 42. Minimally Invasive Surgery Research Center, Tehran, Iran
  43. 43. Ophthalmology Department, Tehran, Iran
  44. 44. Pars Advanced and Minimally Invasive Medical Manners Research Center, Tehran, Iran
  45. 45. Student Research Committee, Tehran, Iran
  46. 46. Iran University of Medical Sciences, Tehran, Iran
  47. 47. Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran
  48. 48. College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
  49. 49. Faculty of Medicine, Mansoura University, Mansoura, Egypt
  50. 50. Department of Epidemiology and Biostatistics, Health Promotion Research Center, Zahedan, Iran
  51. 51. Social Determinants of Health Research Center, Birjand University of Medical Sciences, Iran
  52. 52. Department of Surgery, Debre Tabor University, Debre Tabor, Ethiopia
  53. 53. Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto, ON, Canada
  54. 54. Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
  55. 55. Department of Veterans Affairs, Seattle, WA, United States
  56. 56. Department of Nursing, Mekelle University, Mekelle, Ethiopia
  57. 57. Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
  58. 58. School of Pharmacy, Mekelle University, Mekelle, Ethiopia
  59. 59. Department of Statistical and Computational Genomics, National Institute of Biomedical Genomics, Kalyani, India
  60. 60. Department of Statistics, University of Calcutta, Kolkata, India
  61. 61. Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
  62. 62. Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
  63. 63. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  64. 64. Cancer Registry of Norway, Oslo, Norway
  65. 65. Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Milan, Italy
  66. 66. Department of Oncology, Mario Negri Institute for Pharmacological Research, Milan, Italy
  67. 67. Oncologic Network, Prevention and Research Institute (ISPRO), Florence, Italy
  68. 68. Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
  69. 69. Institute of Public Health, University of Porto, Porto, Portugal
  70. 70. LAQV/ REQUIMTE, University of Porto, Porto, Portugal
  71. 71. Research Unit on Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
  72. 72. Department of Epidemiology, Portuguese Oncology Institute of Porto, Porto, Portugal
  73. 73. Faculty of Biology, Hanoi National University of Education, Hanoi, Viet Nam
  74. 74. Clinical Pharmacy, University of Gondar, Gondar, Ethiopia
  75. 75. Department of Human Physiology, University of Gondar, Gondar, Ethiopia
  76. 76. Department of Public Health, Ambo University, Ambo, Ethiopia
  77. 77. Department of Immunology, Mazandaran University of Medical Sciences, Sari, Iran
  78. 78. Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  79. 79. Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  80. 80. Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  81. 81. Department of Medical Laboratory Sciences, Bahir Dar University, Bahir Dar, Ethiopia
  82. 82. Department of Nursing, Aksum University, Aksum, Ethiopia
  83. 83. School of Pharmacy, Aksum University, Aksum, Ethiopia
  84. 84. School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
  85. 85. Department of Epidemiology and Biostatistics, Shahroud University of Medical Sciences, Shahroud, Iran
  86. 86. Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
  87. 87. College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
  88. 88. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
  89. 89. Department of Biology and Biotechnology L. Spallanzani, University of Pavia, Pavia, Italy
  90. 90. Department of Biology, Salahaddin University-Erbil, Erbil, Iraq
  91. 91. Psychiatry Department, Kaiser Permanente, Fontana, CA, United States
  92. 92. College of Graduate Health Sciences, A.T. Still University, Mesa, AZ, United States
  93. 93. School of Health Sciences, A.T. Still University, Mesa, AZ, United States
  94. 94. Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
  95. 95. Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States
  96. 96. Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, United States
  97. 97. Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, United States
  98. 98. School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
  99. 99. School of Medicine and Public Health, Newcastle University, Newcastle, Australia
  100. 100. Research Group for Genomic Epidemiology, Technical University of Denmark, Copenhagen, Denmark
  101. 101. Research Unit of Social Epidemiology, Lund University, Malmo, Sweden
  102. 102. Health Systems and Policy Research, Indian Institute of Public Health Gandhinagar, Gandhinagar, India
  103. 103. March of Dimes, Arlington, VA, United States
  104. 104. Health Policy, Management and Leadership, West Virginia University School of Public Health, Morgantown, WV, United States
  105. 105. Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, United States
  106. 106. Department of Radiology, Johns Hopkins University, Baltimore, MD, United States
  107. 107. Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, United States
  108. 108. Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  109. 109. Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  110. 110. Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  111. 111. School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  112. 112. Biology Department, Utica College, Utica, NY, United States
  113. 113. Primary and Interdisciplinary Care, University Hospital Antwerp, Antwerp, Belgium
  114. 114. Department of Public Health, Mizan-Tepi University, Mizan Teferi, Ethiopia
  115. 115. Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Viet Nam
  116. 116. Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
  117. 117. Division of Information and Computing Technology, Hamad Bin Khalifa University, Doha, Qatar
  118. 118. Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
  119. 119. Department of Community Medicine, University College Hospital Ibadan, Ibadan, Nigeria
  120. 120. Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
  121. 121. School of Medical Sciences, Kathmandu University, Chitwan, Nepal
  122. 122. Department of Epidemiology and Health Promotion, Yonsei University, Seoul, South Korea
  123. 123. Harvard Medical School, Harvard University, Boston, MA, United States
  124. 124. Department of Community Medicine, Dr Baba Saheb Ambedkar Medical College & Hospital, Delhi, India
  125. 125. Department of Community Medicine, Banaras Hindu University, Varanasi, India
  126. 126. Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
  127. 127. Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
  128. 128. Department of Nursing, Woldia University, Woldia, Ethiopia
  129. 129. Amhara Public Health Institute, Bair Dar, Ethiopia
  130. 130. Hematology/Oncology, St Joseph University Medical Center, Paterson, NJ, United States
  131. 131. Non-communicable Diseases Research Unit, Medical Research Council South Africa, Cape Town, South Africa
  132. 132. Department of Medicine, University of Cape Town, Cape Town, South Africa
  133. 133. Department of Medical Oncology, Pierre & Marie Curie Center, Algiers, Algeria
  134. 134. Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
  135. 135. Biophysics and Molecular Biology, Baku State University, Baku, Azerbaijan
  136. 136. Institute of Radiation Problems, Azerbaijan National Academy of Sciences, Baku, Azerbaijan
  137. 137. Department of Epidemiology and Biostatistics, Health Services Academy, Islamabad, Pakistan
  138. 138. Department of Public Health, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
  139. 139. Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
  140. 140. Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
  141. 141. Brain Engineering Research Center, Institute for Research in Fundamental Sciences, Tehran, Iran
  142. 142. Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States
  143. 143. Clinical Medicine and Community Health, University of Milan, Milano, Italy
  144. 144. Department of Otorhinolaryngology, Father Muller Medical College, Mangalore, India
  145. 145. Department of Sociology, Shenzhen University, Shenzhen, China
  146. 146. Department of Agriculture and Food Systems, University of Melbourne, Melbourne, VIC, Australia
  147. 147. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
  148. 148. Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
  149. 149. Primary Care and Public Health, Imperial College London, London, United Kingdom
  150. 150. WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, United Kingdom
  151. 151. Ophthalmology Department, University of Manitoba, Winnipeg, MB, Canada
  152. 152. General Surgery Department i, Emergency University Hospital Bucharest, Bucharest, Romania
  153. 153. General Surgery Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
  154. 154. Health Policy Research, Public Health Foundation of India, Gurugram, India
  155. 155. Institute of Population Health Sciences, University of Liverpool, Liverpool, United Kingdom
  156. 156. Cardiology Department, West Middlesex University Hospital, London, United Kingdom
  157. 157. Division of Gastroenterology and Hepatobiliary Disease, New York Medical College, Valhalla, NY, United States
  158. 158. Peru Country Office, Lima, Peru
  159. 159. United Nations Population Fund (UNFPA), Lima, Peru
  160. 160. Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
  161. 161. Department of Forensic Medicine, Manipal Academy of Higher Education, Mangalore, India
  162. 162. Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
  163. 163. Tishk International University, Erbil, Iraq
  164. 164. Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
  165. 165. Kashmar Center of Higher Health Education, Mashhad University of Medical Sciences, Mashhad, Iran
  166. 166. Department of Public Health, Samara University, Samara, Ethiopia
  167. 167. Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
  168. 168. Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran
  169. 169. Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
  170. 170. Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, United States
  171. 171. Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
  172. 172. General Surgery Department, Emergency Hospital of Bucharest, Bucharest, Romania
  173. 173. Department of Histopathology, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
  174. 174. Department of Human Pathology, University of Maiduguri, Maiduguri, Nigeria
  175. 175. Institute for Global Health Innovations, Duy Tan University, Hanoi, Viet Nam
  176. 176. Heidelberg University Hospital, Germany
  177. 177. Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
  178. 178. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
  179. 179. Department of Psychiatry, University of Lagos, Lagos, Nigeria
  180. 180. Department of Medicine, Yale University, New Haven, NY, United States
  181. 181. Research & Development Department, Kalinga Institute of Medical Sciences, Bhubaneswar, India
  182. 182. Department of Chemistry, Sharif University of Technology, Tehran, Iran
  183. 183. Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
  184. 184. College of Medicine, University of Central Florida, Orlando, FL, United States
  185. 185. Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
  186. 186. Academic Public Health Support, Public Health England, London, United Kingdom
  187. 187. University College London Hospitals, London, United Kingdom
  188. 188. Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  189. 189. Public Health Department, Wollega University, Nekemte, Ethiopia
  190. 190. Department of Entomology, Ain Shams University, Cairo, Egypt
  191. 191. Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
  192. 192. Department of Medical Statistics, Epidemiology, and Medical Informatics, University of Zagreb, Zagreb, Croatia
  193. 193. Division of Epidemiology and Prevention of Chronic Noncommunicable Diseases, Croatian Institute of Public Health, Zagreb, Croatia
  194. 194. Center for Biomedical Information Technology, Shenzhen Institutes of Advanced Technology, Shenzhen, China
  195. 195. Faculty of Caring Science, Work Life and Social Welfare, University of Boras, Boras, Sweden
  196. 196. Department of Hematology-Oncology, Baystate Medical Center, Springfield, MA, United States
  197. 197. Medical Service Rheumatology, US Department of Veterans Affairs, Birmingham, AL, United States
  198. 198. Department of Epidemiology, School of Preventive Oncology, Patna, India
  199. 199. Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
  200. 200. Department of Research Development, Federal Research Institute for Health Organization and Informatics of the Ministry of Health, Moscow, Russian Federation
  201. 201. Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Moscow, Russian Federation
  202. 202. Axum College of Health Science, Mekelle, Ethiopia
  203. 203. Department of Public Health, Adigrat University, Adigrat, Ethiopia
  204. 204. Division of Biostatistics and Epidemiology, Texas Tech University, El Paso, TX, United States
  205. 205. Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands
  206. 206. Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
  207. 207. Department of Health Economics, Hanoi Medical University, Hanoi, Viet Nam
  208. 208. Department of Microbiology, Iqra National University, Peshawar, Pakistan
  209. 209. TB Culture Laboratory, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan
  210. 210. Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
  211. 211. Faculty of Medicine Institute of Epidemiology, University of Belgrade, Belgrade, Serbia
  212. 212. Department of Health Management, Policy, and Economics, Kerman University of Medical Sciences, Kerman, Iran
  213. 213. Health Services Management Research Center, Kerman University of Medical Sciences, Kerman, Iran
  214. 214. Department of Preventive Oncology, Hacettepe University, Ankara, Turkey
  215. 215. Epidemiology and Cancer Registry Sector, Institute of Oncology Ljubljana, Ljubljana, Slovenia
  216. 216. Department of Medicine, University Ferhat Abbas of Setif, Setif, Algeria
  217. 217. School of Medicine, Wuhan University, Wuhan, China

Source: The Lancet Gastroenterology and Hepatology Published:2020


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 agestandardised 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. © 2020 The Author(s).
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