To analyze the changes in the burden of Disability-Adjusted Life Years (DALY) due to esophageal cancer in China from 1990 to 2021 and to predict the DALY trends over the next 20 years, providing scientific basis for policy-making and public health interventions.

The analysis of DALY changes due to esophageal cancer in China from 1990 to 2021 was conducted using the Global Burden of Disease Study database. Joint point regression analysis was employed to assess the annual percentage change in the DALY rate for esophageal cancer in China, and comparisons were made with North Korea, Japan, South Korea, and the United States. A decomposition analysis was performed to evaluate the contributions of population aging, population growth, and age-specific factors to the changes in esophageal cancer DALY. The Bayesian Age-Period-Cohort (BAPC) model was used to forecast the changes in esophageal cancer DALY over the next 20 years.

In 2021, the total number of DALYs due to esophageal cancer in China was approximately 6.8 987 million years, with a significantly higher burden in males compared to females;individuals aged 65 and older accounted for 52.71% of the total DALYs. Compared to international data, China exhibited a more pronounced declining trend in esophageal cancer DALYs. From 1990 to 2021, the DALY rate decreased, with population aging and growth being the main driving factors for the increase in DALY burden. The BAPC predictive analysis indicated a slow declining trend in the total standardized DALY rate for esophageal cancer in China over the next 20 years.

Over the past 30 years, the burden of DALYs due to esophageal cancer in the Chinese population has shown a significant declining trend, particularly among males and the elderly. Future efforts should focus on enhancing screening coverage and interventions for high-risk populations.