Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jan 28, 2023
Open Peer Review Period: Jan 27, 2023 - Feb 10, 2023
Date Accepted: Sep 5, 2023
(closed for review but you can still tweet)
The spatiotemporal patterns of esophageal cancer burden attributable to behavioral, metabolic, and dietary risk factors from 1990 to 2019: a population-based study
ABSTRACT
Background:
Esophageal cancer (EC) is the sixth leading cause of cancer-related burden with marked regional differences. Although the burden of EC decreases throughout decades of years, but specific attributable reasons are still unclear.
Objective:
This study aims to elucidate the spatiotemporal patterns of EC risk-attributable burden in 204 countries and territories from 1990 to 2019, which would further prioritize global EC prevention and strategies.
Methods:
We extracted risk-attributable EC deaths, disability adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) from GBD 2019, in terms of behavioral factors, metabolic factors and dietary factors. An average annual change percentage (AAPC) was introduced to analyze the trends of the ASMD and ASDR.
Results:
Between 1990 and 2019, the most significant decrease in EC burden was attributed to low intake fruits and vegetables, with AAPC of -2.96 (95%CI: -3.28, -2.63) in ASMR and -3.12 (95%CI:-3.44, -2.79) in ASDR attributable to diet low in fruits, and AAPC of -3.60 (95%CI:-3.84, -3.36) in ASMR and -3.64 (95%CI: -3.92, -3.35) in ASDR attributable to diet low in vegetables. In contrast, the trends of ASMR and ASDR attributable to high BMI showed significant increase from 1990 to 2019, with AAPC of 0.52 (95%CI: 0.29, 0.75) in ASMR and 0.42 (95%CI:0.18, 0.66) in ASDR, comparing with a significant decline in other risk factors with AAPC<0 (P<0.05).
Conclusions:
Although smoking and alcohol use still dominant in EC risk-attributable ASMR and ASDR, a diet low in fruits and vegetables significantly reduces in EC burden. Importantly, the risk-attributable ASMR and ASDR have different spatiotemporal patterns, and we should be aware to the upward trend of the ASMR and ASDR attributable to high BMI.
Citation
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