title: The Global Burden of Esophageal Cancer: A Disability-Adjusted Life-Year Approach.
abstract: BACKGROUND
  Esophageal cancer is the eighth most common cancer worldwide and the sixth leading cause of cancer-related deaths. As a significant cause of morbidity and mortality, its burden on society has yet to be fully characterized. The aim of this study is to examine its global burden through estimation of the disability-adjusted life years (DALYs) attributable to it.
  
  
  METHODS
  Global incidence and mortality estimates for esophageal cancer were obtained from the International Agency for Research on Cancer GLOBOCAN 2008 database. DALYs were calculated, using methodology established by the World Health Organization.
  
  
  RESULTS
  In 2008, 3,955,919 DALYs were attributed to esophageal cancer, at a global rate of 0.58 DALYs per 1000 people annually. Years of life lost (YLL) accounted for 96.8 % of DALYs, while years lived with disability (YLD) accounted for 3.2 %. 83.8 % of the global DALYs occurred in less-developed countries, with most accrued in Eastern Asia, comprising 50.9 % of the total. The highest rate of DALY accrual was in Southern Africa, at 1.62 DALYs per 1000 people annually.
  
  
  CONCLUSIONS
  A substantial number of years of life were lost or affected by esophageal cancer worldwide in 2008, with the burden resting disproportionately on less-developed countries. Geographically, the greatest burden is in Eastern Asia. The vast majority of DALYs were due to YLL, rather than YLD, indicating the need to focus resources on disease prevention and early detection. Our findings provide an additional basis upon which to formulate global priorities for interventions that affect DALY reduction in esophageal cancer.
authors.affiliation: Division of Gastrointestinal and General Surgery, Department of Surgery, Digestive Health Center, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mailcode L223A, Portland, OR, 97239, USA.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Di Pardo
authors.affiliation: Division of Gastrointestinal and General Surgery, Department of Surgery, Digestive Health Center, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mailcode L223A, Portland, OR, 97239, USA.
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Bronson
authors.affiliation: Division of Gastrointestinal and General Surgery, Department of Surgery, Digestive Health Center, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mailcode L223A, Portland, OR, 97239, USA.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Diggs
authors.affiliation: Department of Radiation Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Thomas
authors.affiliation: Division of Gastrointestinal and General Surgery, Department of Surgery, Digestive Health Center, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mailcode L223A, Portland, OR, 97239, USA.
authors.forename: John G
authors.initials: JG
authors.lastname: Hunter
authors.affiliation: Division of Gastrointestinal and General Surgery, Department of Surgery, Digestive Health Center, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mailcode L223A, Portland, OR, 97239, USA. dolanj@ohsu.edu.
authors.forename: James P
authors.initials: JP
authors.lastname: Dolan
mesh_terms: D000293:Adolescent; D000328:Adult; D000353:Africa, Southern / Q000453:epidemiology; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries / Q000706:statistics & numerical data*; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000401:mortality; D005202:Asia, Eastern / Q000453:epidemiology; D005260:Female; D014943:Global Health; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D055815:Young Adult