Article The Burden of Esophageal Cancer in China From 2013 to 2030 A Dynamic Cohort Modeling Study

Abstract

Background: This study aimed to predict the disease burden of esophageal cancer (EC) over the period 2013-2030 in China. Methods : A dynamic cohort Markov model was developed to simulate the EC prevalence, disability-adjusted life years (DALY), and the medical direct expenditure based on gender. JoinPoint Regression Program was used to calculate the average annual percentage change (AAPC) of EC prevalence and DALY rates, while the regression model was applied to analyze the changing trend of economic burden over time. Results: The predicted DALY rates per 100 000 people increased in both-sex (219.17 - 252.39) and males (302.89 – 384.31), while it decreased in females (131.21- 115.91). The years of life lost (YLL) accounted for the majority of DALYs. The AAPC were 0.8%(95% CI, 0.8%-0.9%), 1.4%(95% CI, 1.3%- 1.5%), and -0.7%(95% CI, -0.8%- -0.7%) in both-sex, males and females, respectively. The medical direct expenditure in both-sex, males, and females was predicted to increase by 165.35%, 194.04%, and 94.20%, respectively. Conclusions: EC still caused a severe burden on society. YLL was responsible for the majority of the DALYs, which highly suggesting the implementation of accurate prevention like screening and early diagnosis and treatment programs.