Objective To understand the spatiotemporal distribution of incidence risk of esophageal cancer and related geographical influencing factors risk in Changzhi, Shanxi province, from 2016 to 2022, and provide reference for the prevention and control of esophageal cancer.

Methods A Bayesian spatiotemporal model was established by using the incidence data of esophageal cancer in different districts and counties of Changzhi from 2016 to 2021, and a regression analysis was carried out by using geographical factors which might affect the incidence of esophageal cancer as covariates, such as average annual temperature, average annual precipitation, altitude, slope aspect, vegetation coverage, soil organic matter and soil pH.

Results The case count of esophageal cancer was 1.68 times higher in men than in women in Changzhi from 2016 to 2021, and the annual case counts were all higher in men than in women. From 2016 to 2021, the incidence rate of esophageal cancer in Changzhi showed a significant spatial clustering (Moran's I index=0.25, P=0.031) and the incidence rate declined over time. The regression analysis on geographical factors showed that the annual mean temperature relative risk (RR)=1.31, 95% confidence interval (CI): 1.09–1.50, slope aspect (RR=1.32, 95%CI: 1.18–1.46), altitude (RR=1.19, 95%CI: 1.03–1.36) and soil pH (RR=1.35, 95%CI: 1.21–1.47) were positively correlated with the risk for esophageal cancer, and vegetation coverage (RR=0.46, 95%CI: 0.22–0.68) was negatively correlated with the risk for esophageal cancer.

Conclusion The incidence rate of esophageal cancer in Changzhi has a spatiotemporal distribution pattern of high in the south and low in the north, and is closely related to geographical factors such as average annual temperature, slope aspect, altitude, soil pH and vegetation coverage. The high-risk areas are mainly in the southern counties, suggesting that related risk environmental factors should be considered in the primary prevention and control of esophageal cancer.