Burden of Esophageal Cancer in Asia in 2022 and Projections for 2050

BACKGROUND AND AIM: Esophageal cancer (EC) is a major global health issue, with its burden disproportionately affecting Asia. However, a comprehensive analysis using the latest data and robust future projections for the continent is lacking. We aimed to assess the current EC burden in Asia and project its trajectory to 2050. METHODS: We extracted 2022 incidence and mortality data for 47 Asian countries from the GLOBOCAN database. Age-standardized rates (ASRs) were calculated. We analyzed long-term trends using joinpoint regression and assessed correlations between ASRs and the Human Development Index (HDI). Projections to 2050 were calculated based on demographic changes, assuming constant current cancer rates. RESULTS: In 2022, Asia shouldered a disproportionate global burden, accounting for approximately 75% of new esophageal cancer cases (382 800) and deaths (329 800). The burden was heavily concentrated in males and individuals aged 50 and over, with stark geographical disparities; countries like Bangladesh and Mongolia recorded some of the world's highest age-standardized rates. A significant negative correlation was observed between disease rates and the Human Development Index (HDI) in females (p < 0.05), but not in males. Driven purely by demographic changes (population growth and aging), the number of new cases is projected to increase by 89% to 729 000 and deaths by 97% to 649 000 by 2050. CONCLUSIONS: Asia's immense EC burden is set to nearly double by 2050 due to demographic shifts, which highlights the substantial pressure on healthcare systems. Mitigating this impending crisis requires immediate, evidence-based interventions focusing on risk factor control and stratified screening for high-risk populations.