Objective To integrate and analyze the disease burden of esophageal cancer caused by alcohol consumption in China from 1990 to 2019, along with the differences between genders, and predict the trends in disease burden changes from 2020 to 2029 to improve prevention and treatment strategies. Methods The disease burden of esophageal cancer caused by alcohol consumption in China from 1990 to 2019 was extracted and integrated from the 2019 Global Burden of Disease (GBD) database, and the corresponding trend was analyzed using the Joinpoint regression model with Joinpoint 4.9.1.0 software. The gray prediction model [GM (1, 1) ] was used to forecast the disease burden of alcohol-related esophageal cancer in China from 2020 to 2029. Results In 2019, the leading causes of esophageal cancer in China were tobacco, alcohol, high body mass index, and insufficient fruit and vegetable intake, accounting for the first to fifth positions in esophageal cancer deaths. From a gender perspective, in 2019, the death number and standardized mortality rate for males were 18.97 times and 20.00 times higher than for females, respectively. The disability-adjusted life years (DALYs) and standardized DALYs rate for males were 33.08 times and 24.78 times higher than those for females, respectively, indicating a heavier disease burden of alcohol-related esophageal cancer among Chinese males. From 1990 to 2019, the average annual percentage change (AAPC) in deaths and DALYs due to alcohol-related esophageal cancer in China was 2.08% and 1.63%, respectively, showing a continuous upward trend with statistical significance (P<0.05). The AAPC values for standardized mortality rate and standardized DALYs rate from 1990 to 2019 were –0.92% and –1.23%, respectively, showing a continuous downward trend with statistical significance (P<0.05). The population aged ≥55 years was the main group bearing the disease burden among all age groups from 1990 to 2019. The gray prediction model predicted that by 2029, the overall standardized mortality rate and standardized DALYs rate would decrease to 2.94/100 000and 67.94/100 000, with a greater decline in females than in males. Conclusion Over the past 30 years, the disease burden of alcohol-related esophageal cancer in China has slightly decreased. However, the reduction in disease burden is still lower compared to the overall decline in esophageal cancer burden, and the disease burden for males is significantly higher than for females. Focusing on prevention and treatment for males and the elderly population remains a major issue in addressing alcohol-related esophageal cancer in China.
ObjectiveTo analyze the gender-specific distribution patterns of the disease burden of tracheal, bronchial, and lung cancer (hereinafter referred to as lung cancer) attributed to tobacco from 1990 to 2021 globally and in China and the United States (US), and to predict the trend of disease burden changes from 2022 to 2031, aiming to provide multi-dimensional evidence-based support for optimizing tobacco control strategies and precise lung cancer prevention and control systems. MethodsData on the disease burden of lung cancer attributed to tobacco from 1990 to 2021 globally and in China and the US were extracted and integrated from the Global Burden of Disease (GBD) 2021 database. The Joinpoint 4.9.1.0 software was used to analyze the corresponding trends in disease burden. The Bayesian age-period-cohort (BAPC) prediction model was employed to forecast the disease burden of lung cancer from 2022 to 2031. ResultsIn 2021, China had the highest number of deaths and disability-adjusted life years (DALY) due to lung cancer attributed to tobacco, with 544600 patients and 12.5721 million person-years respectively, followed by the US with 105200 patients and 2.3096 million person-years. The top three risk factors for lung cancer globally and in China and the US from 1990 to 2021 were tobacco, air pollution, and occupational risks. The disease burden of lung cancer patients attributed to tobacco has been decreasing year by year in the global and US populations [the average annual percentage change (AAPC) values of age-standardized mortality rate and DALY rate were: globally: −0.96%, −1.28%; US: −2.33%, −2.72%], while it has been increasing in China (the AAPC values of age-standardized mortality rate and DALY rate were 0.28% and −0.02%, respectively). From a gender perspective, the disease burden of male patients with lung cancer attributed to tobacco was much higher than that of female patients from 1990 to 2021. Compared to the global average, the disease burden of lung cancer attributed to tobacco in China and the US from 1990 to 2021 was still heavy, with China's burden being higher than that of the US. The elderly population aged ≥65 years in both the global context and in China and the US was the primary group affected by the disease burden of lung cancer attributed to tobacco. The BAPC prediction model indicated that from 2022 to 2031, the age-standardized rates of lung cancer attributed to tobacco in the global context and in China and the US would show a declining trend. ConclusionFrom 1990 to 2021, the disease burden of lung cancer attributed to tobacco in China and the US was still heavy compared to the global average, with China's burden being significantly higher than that of the US. The focus on prevention and control for both countries remains among the middle-aged and elderly population (especially males), which is a key challenge for tobacco-related lung cancer prevention and treatment work in the next 10 years.