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Introduction <p>Esophageal cancer (EC) ranks 7th globally in cancer mortality, with smoking being a major preventable risk factor, particularly for squamous cell carcinoma predominant in Asia. This study quantifies the global burden of smoking-attributable EC among males using 2021 Global Burden of Disease data (1990–2021) and projects trends to 2040.</p> Method <p>Data on deaths and Disability-Adjusted Life Years (DALYs) for global burden of smoking-attributable EC among males were derived from the Global Burden of Diseases (GBD) Study 2021, along with the corresponding 95% uncertainty intervals (UIs). We analyzed with Joinpoint regression, age-period-cohort modeling for risk stratification, decomposition analysis, and Bayesian prediction.</p> Results <p>Global smoking-attributable EC deaths and DALYs among males decreased, concentrated in middle-to-high SDI regions. Age-standardized DALY rates (ASDR) declined significantly, with sharpest reductions in medium-SDI regions. East Asia bore disproportionate burden in China and Mongolia. Critical inflection occurred in 2004 by joinpoint and age-period-cohort analysis from 1990 to 2021. Mortality peak at 80–90&#xa0;years and disability peak at 60–80&#xa0;years. Decomposition analysis showed population growth and aging increased burden, offset by epidemiological improvements. Predictive analysis indicated stable-to-declining ASRs through 2040, contingent on sustained tobacco control in high-risk regions.</p> Conclusion <p>The analysis indicated a global downward trend in EC attributable to smoking among males. While absolute burdens rise due to demographic pressures, declining ASRs reflect tobacco control progress. The 2004 inflection underscores policy impact, and East Asia's outsized burden necessitates targeted interventions. Our research underscores the profound influence of high BMI on EC attributable to smoking among males and provides a research foundation for future public health decision-making.</p>

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The global burden and trends of esophageal cancer caused by smoking among men from 1990 to 2021 and projections to 2040: An analysis of the Global Burden of Disease 2021

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月30日

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  • Zhenrui Cao,
  • Haiyan Wang,
  • Yanlin Li,
  • Siying Ye,
  • Jingyao Lin,
  • Tuoyu Li,
  • Jiajie Leng,
  • Yingjiu Jiang,
  • Mengjun Bie,
  • Letai Li

摘要

Introduction

Esophageal cancer (EC) ranks 7th globally in cancer mortality, with smoking being a major preventable risk factor, particularly for squamous cell carcinoma predominant in Asia. This study quantifies the global burden of smoking-attributable EC among males using 2021 Global Burden of Disease data (1990–2021) and projects trends to 2040.

Method

Data on deaths and Disability-Adjusted Life Years (DALYs) for global burden of smoking-attributable EC among males were derived from the Global Burden of Diseases (GBD) Study 2021, along with the corresponding 95% uncertainty intervals (UIs). We analyzed with Joinpoint regression, age-period-cohort modeling for risk stratification, decomposition analysis, and Bayesian prediction.

Results

Global smoking-attributable EC deaths and DALYs among males decreased, concentrated in middle-to-high SDI regions. Age-standardized DALY rates (ASDR) declined significantly, with sharpest reductions in medium-SDI regions. East Asia bore disproportionate burden in China and Mongolia. Critical inflection occurred in 2004 by joinpoint and age-period-cohort analysis from 1990 to 2021. Mortality peak at 80–90 years and disability peak at 60–80 years. Decomposition analysis showed population growth and aging increased burden, offset by epidemiological improvements. Predictive analysis indicated stable-to-declining ASRs through 2040, contingent on sustained tobacco control in high-risk regions.

Conclusion

The analysis indicated a global downward trend in EC attributable to smoking among males. While absolute burdens rise due to demographic pressures, declining ASRs reflect tobacco control progress. The 2004 inflection underscores policy impact, and East Asia's outsized burden necessitates targeted interventions. Our research underscores the profound influence of high BMI on EC attributable to smoking among males and provides a research foundation for future public health decision-making.