Long-term trends in disease burden of esophageal cancer in China and the forecast until 2050

Esophageal cancer (EC) is one of the most common malignant tumors in China, with the number of new cases and deaths accounting for about half of the global total, imposing a heavy burden of disease. The latest epidemiological statistics on EC can help policymakers allocate resources for EC prevention, treatment, and care. The project was designed to comprehensively and reliably evaluate the epidemiology of EC in China and predict its future trends. The Global Burden of Disease (GBD) study 2021 is a comprehensive data platform developed in collaboration with researchers around the world to provide detailed information and analysis on diseases, injuries, and risk factors at global, regional, and national levels for the assessment of disease health trends. Based on this, we extracted data related to China’s EC disease burden from GBD 2021 for 1990–2021. and used the Joinpoint model to fit the trend of age-standardized rates of EC, and calculate the annual percentage change (APC) and average annual percentage change (AAPC). The Bayesian Age-Period-Cohort (BAPC) model was employed to analyze and predict the trend of the disease burden of EC in China from 2022 to 2050. We also analyzed the temporal trend of EC burden in China caused by specific risk factors such as chewing tobacco, a diet with low vegetable intake, high alcohol intake, and smoking. From 1990 to 2021, the number of cases and deaths from EC increased. The age-standardized prevalence rate (ASPR) and age-standardized mortality rate (ASMR) both decreased over the same period, with AAPCs in the general population being − 1.07 (95% CI: -1.23, -0.92) and − 1.98 (95% CI: -2.19, -1.77), respectively. From 1990 to 2021, the number of cases and deaths in most age groups significantly increased, but the crude prevalence rate (CPR) and crude mortality rate (CMR) decreased. Males had a heavier burden on EC. By 2050, the number of cases and deaths from EC was expected to increase significantly, with corresponding increases in ASPR and ASMR for the total population and males. Interestingly, the ASMR for females was projected to be decreasing. In addition, the ASMR of EC caused by four risk factors showed a decreasing trend in both males and females. The prevalence and mortality of EC in China are greatly influenced by age, especially in males. Therefore, the government should take targeted intervention measures, focusing on middle-aged and elderly men as the key population for EC prevention and control, strengthening EC prevention, and improving the health-related quality of life of patients.