Background

The changing patterns of obesity have had a significant impact on the epidemiology of esophageal cancer (EC).

Aims

This study aimed to investigate the specific burden of EC associated with high body mass index (BMI) across different geographical and Sociodemographic Index (SDI) regions, using data from the Global Burden of Disease Study 2019.

Methods

Mortality, age-standardized death rates (ASDR), and disability-adjusted life-years (DALYs) from 1990 to 2019 were analyzed for 204 countries and territories. Decomposition analysis, frontier and health inequality analyses, and age-period-cohort models were employed to examine the factors driving disease burden and to predict future trends.

Results

High BMI contributed to 89,903.9 [95% uncertainty interval (UI): 27,878.9–171,254.6] EC-related deaths, an ASDR of 1.1 (95% UI 0.3–2.1) per 100,000 population, and 2,202,314.1 (681,901.4–4,173,080.3) DALYs in 2019. There was an increasing trend in these figures over the 29-year period. The middle SDI region (31,023.8, 95% UI 9,180.4–62,631.5) and East Asia (36,939.9, 95% UI 9,620.5–81,495) carried the highest burden of EC-related deaths. Disease burden increased across all age groups and genders globally. Population growth was a major factor driving EC deaths across all SDI quintiles. Disparities in disease burden were observed across countries at all development levels. Predictive models indicated a continued increase in EC-related deaths in the next decade.

Conclusions

The study provided a comprehensive understanding of the global burden of EC associated with high BMI over the past decades. Opportunities exist to reduce this burden at all SDI levels through targeted interventions and policies.

中文翻译：

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高体重指数对全球食管癌负担的贡献：1990 年至 2019 年基于人群的研究

背景

肥胖模式的变化对食管癌（EC）的流行病学产生了重大影响。

目标

本研究旨在利用 2019 年全球疾病负担研究的数据，调查不同地理和社会人口指数 (SDI) 地区与高体重指数 (BMI) 相关的 EC 特定负担。

方法

对 204 个国家和地区 1990 年至 2019 年的死亡率、年龄标准化死亡率 (ASDR) 和伤残调整生命年 (DALY) 进行了分析。采用分解分析、前沿和健康不平等分析以及年龄阶段队列模型来研究驱动疾病负担的因素并预测未来趋势。

结果

高 BMI 导致 89,903.9 [95% 不确定区间 (UI)：27,878.9–171,254.6] EC 相关死亡，每 100,000 人的 ASDR 为 1.1 (95% UI 0.3–2.1)，DALY 为 2,202,314.1 (681,901.4–4,173,080.3) 2019. 29年来，这些数字呈上升趋势。中部 SDI 地区（31,023.8，95% UI 9,180.4–62,631.5）和东亚（36,939.9，95% UI 9,620.5–81,495）与 EC 相关的死亡负担最高。全球所有年龄组和性别的疾病负担均有所增加。人口增长是导致所有 SDI 五分位数 EC 死亡的主要因素。不同发展水平的国家之间的疾病负担存在差异。预测模型表明，未来十年与 EC 相关的死亡人数将持续增加。

结论

该研究全面了解了过去几十年来与高 BMI 相关的全球 EC 负担。通过有针对性的干预措施和政策，有机会在所有 SDI 层面减轻这一负担。