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Chapter 1: Burden of Digestive Disorders
Oesophageal cancer
Whilst the two main histological subtypes of oesophageal cancer, oesophageal squamous cell
carcinoma and oesophageal adenocarcinoma, have distinct risk factors and geographical
distributions, due to data limitations they are not currently captured independently in GBD.106
For the 44 member countries combined, age-standardised incidence and mortality rates for
oesophageal cancer have decreased over time (Figure 116). From 2000-2019, agestandardised
incidence rates decreased by around 11% (4.5 to 4 per 100,000) and agestandardised
mortality rates decreased by around 15% (4.1 to 3.5 per 100,000). The total
number of incident cases and deaths in the member countries combined increased by around
20% (50,439 to 60,667) and 16% (47,462 to 54,909), respectively, from 2000-2019.
For the member countries combined, incidence rates increase steadily with age, peaking at
ages 85+ years for women and men (Figure 117). Age-specific incidence rates are higher for
men across all age groups. For both sexes combined, age-specific incidence rates have
decreased from 2000-2019 for most age groups, except for those aged 20-34 years.
Amongst the member countries in 2019, age-standardised incidence rates range from 0.5 to
5.2 and 1.5 to 13 per 100,000 for women and men, respectively, and age-standardised
mortality rates range from 0.4 to 5.7 and 1.6 to 14 per 100,000 for women and men,
respectively (Figure 118; Figure 119).
Age-standardised DALY rates for both sexes combined range from 21 to 209 per 100,000
among the member countries (Figure 120). Several countries within Western Europe have
relatively high age-standardised DALY rates. Of the 44 countries, 11 (25%) have experienced a
percentage change increase in age-standardised DALY rates from 2000-2019.
Proportions of age-standardised DALY rates attributable to smoking, alcohol use and high
BMI range from 22-56%, 2-43% and 23-37%, respectively, among the member countries
(Figure 121). Proportions of burden attributable to alcohol use are generally lower amongst
member countries within Northern Africa and Western Asia compared to Western and
Central and Eastern Europe. Of the 44 countries, 9 (20%) have experienced an increase in the
proportion of burden attributable to smoking, 21 (48%) have experienced an increase in the
proportion of burden attributable to alcohol use, and all have experienced an increase in the
proportion of burden attributable to high BMI, from 2000-2019. Most countries within
Western and Southern Europe have experienced decreases in alcohol attributable burden
from 2000-2019, and all member countries within Western Europe and the Nordic region
have experienced decreases in smoking attributable burden.
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