Global incidence of esophageal cancer by histological and anatomical subtypes

Abstract Esophageal cancer is a major contributor to the global cancer burden, yet comprehensive global assessments of its burden across subtypes are lacking. This study examines the incidence, risk factors, and trends of esophageal cancer by histological and anatomical subtypes, with stratification by sex and age across different countries, using GLOBOCAN 2022 estimates, Cancer Incidence in Five Continents data, and country-level socioeconomic, lifestyle, and metabolic risk-factor indicators. Here we show that Eastern Asia has the highest age-standardized rate (ASR) of incidence of esophageal squamous cell carcinoma (ESCC) (7.2 per 100,000 population) and upper- and middle-third esophageal cancer (6.0), whereas Northern Europe exhibits the highest ASR of incidence of esophageal adenocarcinoma (EAC) (3.2) and lower‑third esophageal cancer (3.6). EAC and lower‑third esophageal cancer generally share risk factors and exhibit increasing trends; in contrast, ESCC and the upper- and middle-third esophageal cancer share a different risk profile and show an overall decreasing trend. In developed regions, EAC and lower‑third esophageal cancer are more common, whereas in developing regions, ESCC and upper- and middle-third esophageal cancer predominate. Our findings may assist the development of tailored prevention strategies based on locally emerging patterns of esophageal cancer subtypes and relevant risk factors.