Global Inequality in the Incidence and Mortality Rates of Esophageal Cancer: A Country-Level Analysis

Background: Esophageal cancer (EC) is among the ten most common cancers and causes-related mortality worldwide. Objectives: To determine the global inequality in the incidence and mortality rates of EC and decomposing of determinants in inequality. Methods: The rates of incidence and mortality about EC were obtained for 172 countries from the global cancer project. The World Bank database was also used to obtain the HDI and its gradient for 169 countries. Inequality in the age-specific incidence and mortality rates of EC was calculated according to the HDI by using the concentration index (CI). We were decomposing CI to determine contributors in inequality. Results: The concentration index was negative for incidence (-0.23) and mortality (-0.25) rates of EC, indicating the higher concentration of the rates among deprived countries. The important contributors in incidence and mortality inequality rates of EC were HDI and Urbanization with about 0.25 absolute contributions. Conclusions: Global inequalities exist in the EC incidence and mortality rates, which have contributed to the cancer-related health disparities worldwide. The important positive contributors in inequalities were HDI and urbanization. These findings suggest that prevention, early detection, and public health education programs and policies should be targeted to reduce global cancer disparities, particularly in low and middle-income developing countries.