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Contribution of High Body Mass Index to the Global Burden of Esophageal Cancer: A Population-Based Study from 1990 to 2019

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Abstract

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.

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Data availability

The data that support the findings of this study are available from the corresponding author upon request.

Abbreviations

APC:

Age-period-cohort

ASDR:

Age-standardized death rate

BAPC:

Bayesian age-period-cohort

CI:

Confidence interval

DALYs:

Disability-adjusted life-years

EAPC:

Estimated annual percentage change

EC:

Esophageal cancer

GBD:

Global burden of disease

SDI:

Sociodemographic Index

UIs:

Uncertainty intervals

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Acknowledgments

We appreciate the work by the GBD 2019 Study for their contributions to epidemiological evidence.

Funding

This work was supported by the National Natural Science Foundation of China Grant (82172642 to W. Wang) and Natural Science Foundation of Guangdong Province (2021A1515011683 to W. Wang).

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Authors and Affiliations

  1. Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Baiyun District, Guangzhou, 510515, Guangdong, China

    Wenjie Li & Wei Wang

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  1. Wenjie Li
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  2. Wei Wang
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Contributions

Wenjie Li: Conceptualization, methodology, data curation, software, and writing-review & editing. Wei Wang: Funding acquisition, project administration, supervision, and validation. The work reported in the paper has been performed by the authors, unless clearly specified in the text.

Corresponding author

Correspondence to Wei Wang.

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Conflict of interest

The authors declare that the study was performed in the absence of the conflict of interest.

Ethical approval

The data utilized in this study were secondary data publicly released from the Global Health Data Exchange query. Informed patient consent was not required due to the nature of the publicly available data.

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Supplementary Information

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10620_2024_8290_MOESM1_ESM.jpeg

Online Abstract Figure: Within the scope of our study, we sought to elucidate the escalating global burden of EC attributed to high body mass index (BMI) over the past few decades, with specific emphasis on regions characterized by a middle Socio-demographic Index (SDI), as well as East Asia. It became evident that population growth has shouldered the primary burden of this disease. Furthermore, our research outcomes provided compelling evidence of viable opportunities to mitigate the burden of obesity-related EC across countries at varying SDI levels. Notably, there will be a continued rise in the global number of deaths attributed to obesity-related EC during the forthcoming decade. Supplementary file1 (JPEG 389 kb)

Supplementary file2 (XLSX 12 kb)

Supplementary file3 (XLSX 26 kb)

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Li, W., Wang, W. Contribution of High Body Mass Index to the Global Burden of Esophageal Cancer: A Population-Based Study from 1990 to 2019. Dig Dis Sci 69, 1125–1134 (2024). https://doi.org/10.1007/s10620-024-08290-3

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