Danpanichkul Pojsakorn, Suparan Kanokphong, Tothanarungroj Primrose, Dejvajara Disatorn, Rakwong Krittameth, Pang Yanfang, Barba Romelia, Thongpiya Jerapas, Fallon Michael B, Harnois Denise, Lui Rashid N, Wallace Michael B, Yang Ju Dong, Roberts Lewis R, Wijarnpreecha Karn
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
Department of Microbiology, Chiang Mai University, Chiang Mai, Thailand.
Gut. 2024 Dec 10;74(1):26-34. doi: 10.1136/gutjnl-2024-333227.
Gastrointestinal cancers comprise nearly one-third of global mortality from cancer, yet the comprehensive global burden of these cancers remains uninvestigated.
We aimed to assess the global, regional and national burden of gastrointestinal cancers.
Data on oesophagus, gastric, colorectal, liver, pancreas and biliary tract cancers were extracted from the Global Burden of Disease 2021 database. Age-standardised incidence rate (ASIR) and age-standardised death rate (ASDR) were calculated by sex, region and Sociodemographic Index (SDI).
In 2021, there were 5.26 million incidences and 3.70 million deaths from gastrointestinal cancer. The greatest burden is from colorectal, followed by gastric, oesophageal, pancreatic, liver and biliary tract cancer. We noted geographical and socioeconomic differences in ASIR and ASDR across all types of cancers. From 2000 to 2021, ASIR increased for colorectal cancer (annual percent change (APC): 0.10%, 95% CI 0.05% to 0.14%), pancreatic cancer (APC: 0.27%, 95% CI 0.14% to 0.41%), and liver cancer from metabolic dysfunction-associated steatotic liver disease (APC: 0.62%, 95% CI 0.58% to 0.67%) and alcohol-related liver disease (APC: 0.26%, 95% CI 0.22% to 0.30%). ASDR increased for pancreatic cancer (APC: 0.18%, 95% CI 0.02% to 0.34%). Higher SDI countries had higher incidence rates for most types of gastrointestinal cancer.
Although the ASIR of oesophageal, gastric and biliary tract cancer has decreased, the ASIR still increased in colorectal, pancreatic and liver cancer from steatotic liver disease. Public policies are important for controlling gastrointestinal cancers-most importantly, reducing alcohol consumption, hepatitis B immunisation and tackling the burden of metabolic diseases.
胃肠道癌症占全球癌症死亡人数的近三分之一，但这些癌症的全球综合负担仍未得到调查。
我们旨在评估胃肠道癌症的全球、区域和国家负担。
从《2021年全球疾病负担》数据库中提取食管癌、胃癌、结直肠癌、肝癌、胰腺癌和胆道癌的数据。按性别、地区和社会人口指数（SDI）计算年龄标准化发病率（ASIR）和年龄标准化死亡率（ASDR）。
2021年，胃肠道癌症的发病例数为526万例，死亡例数为370万例。负担最重的是结直肠癌，其次是胃癌、食管癌、胰腺癌、肝癌和胆道癌。我们注意到所有类型癌症的ASIR和ASDR存在地理和社会经济差异。从2000年到2021年，结直肠癌的ASIR有所上升（年变化百分比（APC）：0.10%，95%置信区间0.05%至0.14%），胰腺癌（APC：0.27%，95%置信区间0.14%至0.41%），以及代谢功能障碍相关脂肪性肝病导致的肝癌（APC：0.62%，95%置信区间0.58%至0.67%）和酒精性肝病导致的肝癌（APC：0.26%，95%置信区间0.22%至0.30%）。胰腺癌的ASDR有所上升（APC：0.18%，95%置信区间0.02%至0.34%）。高SDI国家大多数类型胃肠道癌症的发病率较高。
尽管食管癌、胃癌和胆道癌的ASIR有所下降，但结直肠癌、胰腺癌和脂肪性肝病导致的肝癌的ASIR仍在上升。公共政策对于控制胃肠道癌症很重要——最重要的是，减少酒精消费、乙肝疫苗接种以及应对代谢性疾病的负担。
