Ethnic, sex, and age disparities in esophageal cancer and medical costs: A population‐based study of 18 million people in China

Limited studies examine esophageal cancer (EC) disparities among Chinese ethnic groups. This study compares EC diagnoses and medical costs by ethnicity, sex, and age in Inner Mongolia, China. This retrospective cohort study used data from the Inner Mongolia Regional Health Information Platform from 2012 to 2020. EC patients were identified using the 10th revision of the International Statistical Classification of Diseases code and Chinese text-based diagnoses during a 2-year washout period. We calculated the incidence, mortality, 5-year prevalence, the age-standardized rate (ASR), and survival rate. We further assessed post-diagnosis medical costs during the first year and the first 3 years. A total of 15,022 participants were identified as having EC, with esophageal squamous cell carcinoma dominant (78.34%). From 2014 to 2020, the crude incidence was 13.03 per 100,000, with a higher incidence observed in the Mongolian ethnicity (Mongolian-to-Han ASR ratio: 2.81:1) and males (male-to-female ASR ratio: 8.65:1). The crude mortality was 7.00 per 100,000, with higher rates in the Mongolian ethnicity and males. The 5-year prevalence showed similar results. Mongolian ethnicity had a similar 5-year survival rate to Han ethnicity, while males had a higher 5-year survival rate. Median post-diagnosis medical costs during the first year and the first 3 years were $7197.87 and $9696.75, with lower costs among the Mongolian ethnicity and females. Mongolian ethnicity and males face a higher EC burden, and related medical costs are higher for males and the Han ethnicity, underscoring the urgent need to address disparities in minority ethnic groups.