Disease Burden of Esophageal Cancer Attributable to Smoking from 1990 to 2019 in China / 中山大学学报(医学科学版)

ABSTRACT

ObjectiveTo analyze the trends in the disease burden of esophageal cancer attributed to smoking in China from 1990 to 2019. MethodsUsing the Joinpoint 4.9.1.0 software， based on the Global Burden of Disease Study 2019 data， we examined the mortality， Disability-Adjusted Life Years （DALY） data， and death rates of esophageal cancer attributed to smoking in China from 1990 to 2019， along with national population data. The trends in disease burden was described and the age-period-cohort model was employed to analyze the effects of age， period， and cohort on the trends in disease burden due to smoking. ResultsJoinpoint analysis indicated that the age-standardized mortality rate （ASMR） and DALY rate attributable to smoking showed an average annual percent change （AAPC） of -1.42% and -1.72%， respectively. For females， the AAPC values for ASMR and DALY rate were -3.26% and -3.70%， respectively， while for males， these were -1.28% and -1.54%， respectively. The disease burden by age attributable to smoking showed a general declining trend across all age groups in mortality and DALY rates. The disease burden from smoking， measured by age， displayed a consistent downward trend in both mortality and DALY rates across all age groups. The 40-44 age group saw the sharpest decline， with Annual Average Percent Changes （AAPC） of -3.05% for mortality and -3.04% for DALY rates. This was closely followed by the 45-49 age group， which experienced AAPC values of -2.73% and -2.72%， respectively. Analysis using the age-period-cohort model showed that the impact of age on mortality and DALY rates due to smoking initially increases with age before subsequently decreasing. The period effect revealed a general increase in the mortality rate from smoking in China， except for a dip between 2005 and 2010； otherwise， the trend was upward over time. The DALY rate demonstrated variability across different periods. The cohort effect indicated a decrease in both mortality and DALY rates due to smoking as successive birth cohorts progressed. ConclusionsOur study reveals that the disease burden of esophageal cancer attributed to smoking factors exhibits gender differences and shows an overall declining trend over time. Efforts should be intensified to enhance health education for men， particularly focusing on smoking cessation education for smokers aged 35-39， in order to improve the overall level of primary prevention of esophageal cancer.