The global landscape of esophageal squamous cell carcinoma and esophageal adenocarcinoma incidence and mortality in 2020 and projections to 2040: New estimates from GLOBOCAN 2020

Background & Aims
To provide an overview of the burden of esophageal cancer in 185 countries in 2020 and projections for the year 2040.

Methods
Estimates of esophageal cancer cases and deaths were extracted from the GLOBOCAN database for 2020. Age-standardized incidence and mortality rates were calculated overall, by sex, histological subtype (adenocarcinoma – AC; squamous cell carcinoma – SCC), country and level of human development for 185 countries. The predicted burden of incidence and mortality in 2040 was calculated based on global demographic projections.

Results
Globally, there were an estimated 604,100 new cases of and 544,100 deaths from esophageal cancer in 2020, corresponding to age-standardized incidence and mortality rates of 6.3 and 5.6 per 100,000, respectively. Most cases were SCCs (85%, 512,500 cases), 14% (85,700 cases) were ACs. Incidence and mortality rates were 2- to 3-fold higher in males (9.3 and 8.2, respectively) compared to females (3.6 and 3.2, respectively). Global variation in incidence and mortality was observed across countries and world regions with highest rates occurring in Eastern Asia, Southern and Eastern Africa and lowest occurring in Western Africa and Central America regions. If rates remain stable, 957,000 new cases (141,300 AC and 806,000 SCC cases) and 880,000 deaths from esophageal cancer are expected in 2040.

Conclusions
These updated estimates of the global burden of esophageal cancer represent an important baseline for setting priorities in policymaking and developing and accelerating cancer control initiatives to reduce the current and projected burden. While primary prevention continues to remain key, screening and early detection represent important components of esophageal cancer control in high-risk populations.