Zhou Haoyun, Wang Yongbo, Wang Fang, Meng Runtang, Yu Yong, Han Su, Zhang Yu, Wu Yu, Liu Xiaoxue
Global Health Research Division, Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China.
Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
Discov Oncol. 2025 Jan 13;16(1):41. doi: 10.1007/s12672-025-01762-6.
New cases and deaths of gastrointestinal cancers are predicted to increase significantly by 2040. This study aims to explore cross-country inequalities and trends in global burdens of colon and rectum cancer (CRC), esophageal cancer (EC) and gastric cancer (GC).
Data from the Global Burden of Diseases Study 2019 were analyzed to examine trends in disability-adjusted life-years (DALYs) for three gastrointestinal cancers with estimated annual percentage change (EAPC) and Joinpoint analysis. Inequality in their DALYs rates was assessed with the slope index of inequality and the concentration index, based on the Socio-Demographic Index (SDI).
From 1990 to 2019, the age standardized DALYs rate of CRC decreased in these countries from high and high-middle SDI regions, with the EAPC values of - 1.018% and - 0.161%, respectively, but increased among low, low-middle and middle SDI regions (EAPC = 1.035%, 0.926% and 0.406%, respectively). The age standardized DALYs rates of EC and GC decreased in all SDI regions. Moreover, the slope index changed from 358.42 (95% confidence interval 343.28 to 370.49) to 245.13 (217.47 to 271.24) for CRC, from - 63.88 (- 87.48 to - 48.28) to - 1.36 (- 32.44 to 25.87) for EC, and from 126.37 (101.97 to 146.47) to 58.04 (20.54 to 96.12) for GC. The concentration index for CRC moved from 29.56 (28.99 to 29.84) to 23.90 (23.19 to 24.26), from - 9.47 (- 10.30 to - 9.24) to - 14.64 (- 15.35 to - 14.24) for EC, and from 8.44 (7.85 to 8.72) to - 6.42 (- 7.65 to - 6.12) for GC.
This study suggests strong heterogeneity in global DALYs for gastrointestinal cancers across different SDI regions. Higher SDI regions faced a greater burden of CRC, while the burdens of EC and GC were more prevalent in lower SDI regions.
预计到2040年，胃肠道癌症的新发病例和死亡人数将显著增加。本研究旨在探讨全球结肠癌、直肠癌（CRC）、食管癌（EC）和胃癌（GC）负担的跨国不平等现象及趋势。
分析全球疾病负担研究2019年的数据，以检验三种胃肠道癌症的伤残调整生命年（DALYs）趋势，采用估计年百分比变化（EAPC）和Joinpoint分析。基于社会人口指数（SDI），用不平等斜率指数和集中指数评估其DALYs率的不平等情况。
1990年至2019年，高SDI地区和高中等SDI地区这些国家的CRC年龄标准化DALYs率下降，EAPC值分别为-1.018%和-0.161%，但在低SDI地区、低中等SDI地区和中等SDI地区有所上升（EAPC分别为1.035%、0.926%和0.406%）。所有SDI地区的EC和GC年龄标准化DALYs率均下降。此外，CRC的斜率指数从358.42（95%置信区间343.28至370.49）变为245.13（217.47至271.24），EC从-63.88（-87.48至-48.28）变为-1.36（-32.44至25.87），GC从126.37（101.97至146.47）变为58.04（20.54至96.12）。CRC的集中指数从29.56（28.99至29.84）变为23.90（23.19至24.26），EC从-9.47（-10.30至-9.24）变为-14.64（-15.35至-14.24），GC从8.44（7.85至8.72）变为-6.42（-7.65至-6.12）。
本研究表明，不同SDI地区全球胃肠道癌症DALYs存在强烈的异质性。较高SDI地区面临更大的CRC负担，而EC和GC负担在较低SDI地区更为普遍。
