Esophageal cancer due to dietary risk factors Deaths Trends Globally, Regionally, and Nationally, 1990-2021: An Age-Period-Cohort Analysis

Background Esophageal cancer due to dietary risks (ECD) remains a global health challenge, with burden varying by dietary habits, tobacco and alcohol use. This study examines global, regional, and national ECD death trends from 1990 to 2021 using an age-period-cohort (APC) model to explore influences of aging, temporal changes, and generational shifts. Methods Data from the Global Burden of Disease Study 2021, encompassing 204 countries and territories, were analyzed. APC modeling was applied to assess crude and age-standardized death rates, alongside percentage changes from 1990 to 2021. Key metrics included net drift coefficients and relative death risks across age groups, periods, and cohorts. Results Global ECD cases decreased from 74,453.71 in 1990 to 56,939.09 in 2021, with an age-standardized death rate of 0.66 (95% CI: -0.14, 1.38) per 100,000 population. High SDI regions showed the highest overall ECD death rate (1.25, 95% CI: -0.27, 2.54 per 100,000), while low SDI regions exhibited the highest age-standardized death rate (1.48, 95% CI: -0.3, 2.88 per 100,000). India, China, USA, and Brazil reported the highest national ECD cases, with significant variations across age groups and regions. Conclusion A global decline in age-standardized ECD death rates is observed, especially in high-middle and middle SDI regions. Nonetheless, low SDI regions continue to experience higher rates, underscoring the need for enhanced public health interventions, including better healthcare access, early detection, and dietary modifications to reduce ECD deaths and address socioeconomic disparities.