Regional trends in esophageal cancer burden across Africa, 1990–2023: A Global Burden of Disease study.

Abstract

e16042 Background: Esophageal cancer is a major contributor to cancer-related mortality in Africa, with marked regional disparities; this study assesses long-term trends in its burden using the Global Burden of Disease (GBD) 2023 study. Methods: Age-standardized death rates (ASDRs), age-standardized incidence rates (ASIRs), age-standardized prevalence rates (ASPRs), and disability adjusted life years (DALYs) per 100,000 population were obtained for African regions based on GBD classifications, including Northern, Central, Eastern, Western, and Southern Africa, as well as the African Union aggregate.Trends were assessed using joinpoint regression with average annual percentage change (AAPC) used to quantify long-term trends. Statistical significance was determined p-value (< 0.05). Results: Between 1980 and 2023, ASDRs increased significantly in Central Africa (AAPC: 0.43; 95% CI 0.32–0.55; p < 0.00001), Northern Africa (AAPC: 0.43; 95% CI 0.27–0.59; p < 0.00001), and Western Africa (AAPC: 0.16; 95% CI 0.05–0.27; p = 0.003663), while Southern Africa experienced a significant decline (AAPC: −0.69; 95% CI −0.92 to −0.46; p < 0.00001). Eastern Africa and the African Union demonstrated stable trends with non-significant changes over time. A similar pattern was observed for ASPR, with significant increases in Central Africa (AAPC: 0.47; 95% CI 0.27–0.66; p = 0.000002), Northern Africa (AAPC: 0.44; 95% CI 0.22–0.66; p = 0.000095), and Western Africa (AAPC: 0.16; 95% CI 0.023–0.30; p = 0.0221), contrasted by a decline in Southern Africa (AAPC: −0.57; 95% CI −0.86 to −0.27; p = 0.000127). ASIR increased persistently in Central Africa (AAPC: 0.65; 95% CI 0.50–0.79; p < 0.000001), Eastern Africa (AAPC: 0.30; 95% CI 0.10–0.50; p = 0.0025), Northern Africa (AAPC: 0.37; 95% CI 0.062–0.69; p = 0.0186), and Western Africa (AAPC: 0.33; 95% CI 0.23–0.43; p < 0.000001), whereas Southern Africa showed a significant reduction (AAPC: −0.63; 95% CI −0.92 to −0.34; p = 0.000022). No significant change in ASIR was observed for the African Union. Trends in DALYs mirrored mortality patterns, with significant increases in Central Africa (AAPC: 0.55; 95% CI 0.42–0.69; p < 0.000001), Eastern Africa (AAPC: 0.22; 95% CI 0.0092–0.44; p = 0.0411), and Western Africa (AAPC: 0.27; 95% CI 0.17–0.37; p < 0.000001), alongside a marked decline in Southern Africa (AAPC: −0.64%; 95% CI −0.95 to −0.34; p = 0.000028). No significant DALY trends were observed in Northern Africa. Conclusions: Despite declines in Southern Africa, esophageal cancer incidence, mortality, and DALYs continue to rise in several African regions highlighting the need for geographically targeted prevention, early detection, and cancer control strategies. ↑ significant increase; ↓ significant decrease; NS non-significant trend (p>0.05). African Region ASDR ASIR ASPR DALYs Central ↑ ↑ ↑ ↑ Northern ↑ ↑ ↑ NS Western ↑ ↑ ↑ ↑ Eastern NS ↑ NS ↑ South ↓ ↓ ↓ ↓ African Union NS NS NS NS