ORIGINAL RESEARCH article
Front. Public Health
Sec. Life-Course Epidemiology and Social Inequalities in Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1696850
Esophageal cancer mortality trends in the United States: a comprehensive l ongitudinal study (1999–2023) using CDC WONDER data
Provisionally accepted
- Zhejiang Chinese Medical University, Hangzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Esophageal cancer continues to pose a significant public health challenge worldwide. However, the extent to which advancements in treatment have reduced mortality at the population level remains unclear. This study examines trends in esophageal cancer mortality in the United States from 1999 to 2023, focusing on variations by sex, racial and ethnic groups, urbanization level, census region, and age group. Methods: Mortality data were obtained from the CDC WONDER database using ICD-10 codes C15.0-C15.9 to identify esophageal cancer-related deaths. The analysis included individuals aged 25 years and older. Temporal trends in age-adjusted mortality rates (AAMR) were analyzed using the Joinpoint Regression Program. Data were stratified by race, census region, metropolitan/nonmetropolitan residence, and state. Annual percentage change (APC) and average annual percentage change (AAPC) were calculated along with their 95% confidence intervals. Results: Between 1999 and 2023, a total of 357,606 deaths from esophageal cancer were recorded. A significant decline in mortality was observed over this period, with the overall AAMR decreasing from 6.74 to 5.61 per 100,000, corresponding to an AAPC of -0.81* (*P < 0.05). Declines in mortality were evident across nearly all racial and ethnic groups, with the exception of non-Hispanic Whites. The most pronounced reduction occurred among non-Hispanic Black individuals (AAPC: -4.07*). Significant sex-based disparities persisted throughout the study period, with males consistently experiencing higher mortality than females. Geographically, mortality trends diverged: metropolitan areas experienced a significant decline (AAPC: -1.09*), whereas nonmetropolitan areas saw a significant increase (AAPC: 0.48*). Pronounced regional disparities were also noted, with the western and northeastern regions demonstrating the most substantial improvements. Age-specific analyses revealed significant mortality reductions in most age groups; however, among adults aged 85 years and older, mortality rates remained stable. Conclusion: Despite an overall decline in esophageal cancer mortality, significant disparities persist across racial, geographic, urban–rural, and age subgroups. These findings highlight the need for targeted public health interventions to address ongoing inequalities, particularly among NH Whites, nonmetropolitan populations, and older adults.
Keywords: CDC WONDER, esophageal cancer, Age-adjusted mortality rates, mortality trends, Epidemiology
Received: 11 Sep 2025; Accepted: 14 Oct 2025.
Copyright: © 2025 Yang, Shao, Guo, Huang and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Heran Zhou, heranzhou100@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.