1990—2019年中国归因于烟草的食管癌疾病负担趋势和死亡预测分析

Background The disease burden of esophageal cancer is high in Chinamore and more studies have shown that tobacco has a greater adverse effect on the development of esophageal cancer. Objective To understand trends inesophageal cancer deaths and burden of disease attributable to tobacco in China from 1990 to 2019and provide data to inform the development of public health policies and interventions. Methods Global burden of disease 2019 GBD 2019 data were used to extract the age-specific and sex-specific data on esophageal cancer deaths attributable to tobacco in China from 1990 to 2019. Mortalitydisability adjusted life yearsDALYsyears of life lostYLLsand disability adjusted life years YLDs were used to assess the disease burden of esophageal cancer attributable to tobacco in China. Joinpoint regression software and ageperiod-cohort modeling methods were applied to analyze the trends of disease burden and mortality with ageperiod and cohort. the Bayesian-period-cohort analysis BAPC was applied to predict the mortality rate of esophageal cancer attributable to tobacco in China from 2020 to 2030. Results From 1990 to 2019the number of deaths caused by esophageal cancer attributable to tobacco among Chinese residents rose from 76400 to 123900with an increase of 62.17%and the standardized mortality rate declined from 9.30/100 000 to 6.20/100 000with a decrease of 33.33%the DALYs rose from 1972500 person-years to 2822600 person-yearswith an increase of 43.10%and the DALYs rate decreased from 220.50/100 000 to 134.47/100 000with a decrease of 39.02%. In terms of genderthe disease burden of esophageal cancer attributable to tobacco was mainly caused by maleswith 117700 deaths and a standardized mortality rate of 12.82/100 000 in 2019 due to tobacco-attributable esophageal cancer in malescompared to 0.62 million deaths number and a standardized mortality rate of 0.63/100 000 in females. In 2019the number of esophageal cancer deaths attributable to tobacco among Chinese residents peakedin the age group of >69-74 yearswhile DALYs peaked in the age group of >64-69 yearsat 23000 and 510300 casesrespectively. The mortality rate continued to increase with ageespecially after 50 years of age. The results of Joinpoint regression analysis showed that the AAPC value of esophageal cancer mortality attributable to tobacco was -1.495%CI-1.6-1.2 in China from 1990 to 2019with -3.395%CI-3.6-2.9 for femalesand -1.395%CI-1.4-1.1 for malesthe AAPCfor DALYs rate was -1.795%CI-1.9-1.5with -3.795%CI-4.0-3.4 for females and -1.595%CI-1.7-1.3 for males. Analysis of the age-period-cohort model of mortality from esophageal cancer attributable to tobacco showed a negative net offset of -1.690%95%CI-2.024%-1.354%. It is expected that the number of deaths and mortality rates from tobacco-attributable esophageal cancer among Chinese residents will be relatively stable with a small decrease from 2020 to 2030with mortality rates declining from 12.64/100 000 in 2020 to 12.63/100 000 in 2030 for malesand from 0.6/100 000 in 2020 to 0.46/100 000 for females. Conclusion Mortality rates and DALYs due to tobacco-attributable esophageal cancer among Chinese residents increased and then declined from 1990 to 2019. The burden of disease due to tobacco-attributable esophageal cancer is mainly caused by males in term of genderby middle-aged and elderly people by agewhich should be given sufficient attention. It is expected that the number of deaths and mortality rates from tobacco-attributable esophageal cancer will be stable and slightly decreasing from 2020 to 2030.