A total of 6488 (68% males) were diagnosed with ESCC (2698, 54% males) and GEJC (3790, 78% males) between 2009 and 2018 (Supplementary Table 1) in Victoria, Queensland, Tasmania, and Australian Capital Territory.

GEJC and ESCC incidence

In general, GEJC incidence rates were higher than ESCC during 2009–2018 (Fig. 1A). Females were more likely to be diagnosed with ESCC than GEJC (Fig. 1C), while males had a higher incidence of GEJC than ESCC (Fig. 1B).

Fig. 1

Incidences of GEJC and ESCC per 1,000,000 person-years (A) overall, (B) in males, and (C) in females. Abbreviations ESCC, esophageal squamous cell carcinoma; GEJC, gastroesophageal junction carcinoma

The average incidence rate of GEJC between 2009 and 2018 was higher in males (41.88 [(95% CI: 38.33–45.44), P = < 0.05] per 1,000,000 person-years), with a statistically significant average annual change, β1 (1.86 [(95% CI: 1.29–2.43), P < 0.05] per 1,000,000 person-years; Table 1).

Table 1 Change in incidence, annual point prevalence, and mortality rates of GEJC and ESCC between 2009–2018Prevalence

The annual point prevalence of GEJC was generally higher than ESCC between 2010 and 2018 (Fig. 2A; Table 1). Within subtypes, the prevalence of GEJC was higher in males (Fig. 2B) and the prevalence of ESCC was greater in females (Fig. 2C).

Fig. 2

Annual point prevalence of GEJC and ESCC per 1,000,000 population (A) overall, (B) in males, and (C) in females. Abbreviations ESCC, esophageal squamous cell carcinoma; GEJC, gastroesophageal junction carcinoma

Mortality and survival

The average mortality between 2010 and 2018 was higher for GEJC; more females died due to ESCC annually (β0 = 14.34 [(95% CI: 0.61–18.07), P = < 0.05] per1,000,000 population) than females with GEJC (β0 = 9.56 [(95% CI: 6.34–12.78), P < 0.05]) per 1,000,000 population (Fig. 3C; Table 1).

Fig. 3

Mortality of GEJC and ESCC per 1,000,000 population (A) overall, (B) in males, and (C) in females. Abbreviations GEJC, gastroesophageal junction carcinoma; ESCC, esophageal squamous cell carcinoma

The 10-year survival rate was about 11% for ESCC and 20% for GEJC, respectively (P < 0.05; Fig. 4).

Fig. 4

Ten-year post-diagnostic survival using Kaplan-Meier survival estimates for GEJC and ESCC. Abbreviations GEJC, gastroesophageal junction carcinoma; ESCC, esophageal squamous cell carcinoma

Gastroesophageal junction carcinomaIncidence - GEJC

The overall incidence rate trend of the GEJC was increasing (2009–2018; Fig. 5A). The incidence, prevalence, and mortality were higher for males than for females for GEJC (Fig. 5). The incidence was predicted to rise in the overall population (29.92 to 54.37, an 82% increase over 30 years) and in the male population (44.74 to 97.69, a 118% increase over 30 years; Supplementary Table 2). In males, the average annual growth was higher at 1.86 ([95% CI: 1.29–2.43], P = < 0.05) per 1,000,000 person-years (Table 1). The GEJC in females showed a negative trend (15.26 to 12.35, a 19% decrease over 30 years), with a − 0.08 ([95% CI: − 0.39 to 0.24], P = 0.596) per 1,000,000 person-years average annual decline (Table 1 and Supplementary Table 2).

Fig. 5

Incidences, annual point prevalence, and mortality of GEJC. (A) per 1,000,000 person-years, (B) and (C) 1,000,000 population. Abbreviation GEJC, gastroesophageal junction carcinoma

Annual point prevalence - GEJC

The regression analysis showed an average prevalence of 21.66 ([95% CI: 17.06–26.26], P = < 0.05) per 1,000,000 population and an average annual point prevalence change of 8.86 ([95% CI: 8.04–9.67], P = < 0.05) over 2010–2018 (Table 1). The average point prevalence was higher in males with 32.36 ([95% CI: 23.76–40.96], P = < 0.05) per 1,000,000 population, compared with females with 11.01 ([95% CI: 9.59–12.42], P = < 0.05) per 1,000,000 population (Table 1). The prevalence grew rapidly in males, with an annual average increase of 14.45 ([95% CI: 12.93–15.98], P = < 0.05) per 1,000,000 population over the 10-year study period (Fig. 5B; Table 1).

Mortality - GEJC

The average mortality between 2010 and 2018 was 19.70 ([95% CI: 13.84–25.56], P = < 0.05) per 1,000,000 population overall. It was higher in males 20.27 ([95% CI: 20.27–39.6], P = < 0.05) per 1,000,000 population compared with females 9.56 ([95% CI: 6.34–12.78], P = < 0.05) per 1,000,000 population (Fig. 5C; Table 1).

Survival - GEJC

According to Kaplan-Meier survival estimates, males (20%) and females (21%) diagnosed with GEJC had similar survival rates without significant differences between sexes (hazard ratio 1.00 [95% CI: 0.91–1.10], P = 0.931; Fig. 6).

Fig. 6

Ten-year post-diagnostic survival using Kaplan-Meier survival estimates for GEJC. Abbreviation GEJC, gastroesophageal junction carcinoma

Esophageal squamous cell carcinomaIncidence - ESCC

The overall ESCC incidence rates showed a slight increase (3%) in 2018 compared with 2009. The incidence increased by 14% from 2009 to 2039 in the overall population (Supplementary Table 1). The incidence, prevalence, and mortality rates in males were higher than in females for ESCC (Fig. 7). However, the average annual growth in males showed a negative trend of − 0.03 ([95% CI: − 0.46 to 0.4], P = 0.884) per 1,000,000 person-years (Table 1), indicating a potential decreasing incidence trend.

Fig. 7

Incidences, annual point prevalence, and mortality of ESCC. (A) per 1,000,000 person-years, (B) and (C) 1,000,000 population. Abbreviation ESCC, esophageal squamous cell carcinoma

Annual point prevalence - ESCC

The regression analysis conducted for the annual point prevalence showed an average of 18.36 ([95% CI: 17.06–19.65], P < 0.05) per 1,000,000 population and an annual point prevalence change of 4.42 ([95% CI: 4.19–4.65], P < 0.05) per 1,000,000 population over 2010–2018. The average annual point prevalence was slightly higher in males at 17.89 ([95% CI: 12.53–23.25], P < 0.05) per 1,000,000 population compared with females at 16.91 ([95% CI: 15.12–18.71], P < 0.05) per 1,000,000 population (Table 1). Both males and females had similar average annual changes from 2010 to 2018 while continuing to move closer toward 2039 (Fig. 1; Table 1).

Mortality - ESCC

The average mortality across the years 2010–2018 was greater in males (19.55 [95% CI: 11.98–27.12]) per 1,000,000 population when compared with females (14.34 [95% CI: 10.61–18.07]) per 1,000,000 population. However, female ESCC-related mortalities increased rapidly at 0.22 (95% CI: − 0.44 to 0.89) per year per 1,000,000 population, a higher rate than in males at 0.13 ([95% CI:–1.21 to 1.48, P = 0.824]) per year per 1,000,000 population (Fig. 7B).

Survival – ESCC

According to Kaplan-Meier survival analysis, females (16%) had a higher 10-year survival rate than males (9%), with a hazard ratio of 0.77 ([95% CI: 0.70–0.84], P = < 0.05; Fig. 8).

Fig. 8

Ten-year post-diagnostic survival using Kaplan-Meier survival estimates for ESCC. Abbreviation ESCC, esophageal squamous cell carcinoma