Wang Jiayi, Li Deming, Ye Fangzhou, Li Jian, Qing Zhe, Zhang Xiaohong, Li Huanqing, Feng Li
Endoscopy Center, Minhang District Central Hospital of Fudan University, Shanghai, China.
J Gastroenterol Hepatol. 2025 Jun;40(6):1525-1535. doi: 10.1111/jgh.17012. Epub 2025 May 22.
The researches on the global burden of digestive system malignancy in young populations were limited. This study aimed to comprehensively investigate the burden of early-onset digestive system malignancy (often defined as cancers diagnosed below the age of 50) based on the Global Burden of Disease 2021.
Data of incidence, prevalence, deaths, disability-adjusted life years (DALYs), and risk factors for the five major early-onset digestive system malignancies, including early-onset esophageal cancer (EOEC), early-onset gastric cancer (EOGC), early-onset liver cancer (EOLC), early-onset pancreatic cancer (EOPC), and early-onset colorectal cancer (EOCRC), were extracted from GBD 2021. The average annual percent change (AAPC) was calculated using joinpoint regression analysis. The Bayesian age-period-cohort (BAPC) model was utilized to predict the burden up to 2030.
From 1990 to 2021, the age-standardized incidence rate (ASIR) of early-onset digestive system malignancies, except for EOCRC (AAPC, 0.37), showed a decreasing pattern. Meanwhile, the age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) of early-onset digestive system malignancy presented a downward trend. Notably, high-middle sociodemographic index (SDI) countries experienced higher disease burdens. Dietary risk factors, tobacco, alcohol consumption, and metabolic factors were the main risk factors. The ASIR of EOEC and EOCRC was projected to increase in 2030, whereas the trend for EOGC, EOLC, and EOPC was projected to decrease.
Early-onset digestive system malignancy presented notable heterogeneity across gender, geography, and cancer types. This emphasizes the urgency of addressing the public health challenge of early-onset digestive system malignancy.
关于年轻人群消化系统恶性肿瘤全球负担的研究有限。本研究旨在基于《2021年全球疾病负担》全面调查早发性消化系统恶性肿瘤（通常定义为50岁以下诊断出的癌症）的负担。
从《2021年全球疾病负担》中提取了五种主要早发性消化系统恶性肿瘤的发病率、患病率、死亡率、伤残调整生命年（DALYs）及危险因素数据，这五种肿瘤包括早发性食管癌（EOEC）、早发性胃癌（EOGC）、早发性肝癌（EOLC）、早发性胰腺癌（EOPC）和早发性结直肠癌（EOCRC）。采用连接点回归分析计算平均年度百分比变化（AAPC）。利用贝叶斯年龄-时期-队列（BAPC）模型预测至2030年的负担。
1990年至2021年，除EOCRC（AAPC，0.37）外，早发性消化系统恶性肿瘤的年龄标准化发病率（ASIR）呈下降趋势。同时，早发性消化系统恶性肿瘤的年龄标准化死亡率（ASMR）和年龄标准化伤残调整生命年率（ASDR）呈下降趋势。值得注意的是，社会人口学指数（SDI）为高中水平的国家疾病负担更高。饮食危险因素、烟草、酒精消费和代谢因素是主要危险因素。预计2030年EOEC和EOCRC的ASIR将上升，而EOGC、EOLC和EOPC的趋势预计将下降。
早发性消化系统恶性肿瘤在性别、地域和癌症类型方面存在显著异质性。这凸显了应对早发性消化系统恶性肿瘤公共卫生挑战的紧迫性。
