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. 2025 Jun;40(6):1525-1535.
doi: 10.1111/jgh.17012. Epub 2025 May 22.

Global Epidemiology of Early-Onset Digestive System Malignancy: A Systematic Analysis for the Global Burden of Disease Study 2021

Jiayi Wang  1 , Deming Li  1 , Fangzhou Ye  1 , Jian Li  1 , Zhe Qing  1 , Xiaohong Zhang  1 , Huanqing Li  1 , Li Feng  1
Affiliations

Global Epidemiology of Early-Onset Digestive System Malignancy: A Systematic Analysis for the Global Burden of Disease Study 2021

Jiayi Wang et al. J Gastroenterol Hepatol. 2025 Jun.

Abstract

Background and aim: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: early‐onset digestive system malignancy; epidemiology; risk factor; trend in global burden.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
The APC and AAPC of ASR for incidence (A), prevalence (B), deaths (C), and DALYs (D) in early‐onset digestive system malignancy at the global level based on the joinpoint regression analysis model.
FIGURE 2
FIGURE 2
Frontier analysis based on the age‐standardized rates of DALYs for early‐onset esophagus cancer (A,B), early‐onset gastric cancer (C,D), early‐onset liver cancer (E,F), pancreatic cancer (G,H), and early‐onset colon and rectum cancer (I,J) and SDI over the decades (1990–2021) and specifically in 2021.
FIGURE 3
FIGURE 3
The risk factors of early‐onset esophagus cancer (A), early‐onset gastric cancer (B), early‐onset liver cancer (C), pancreatic cancer (D), and early‐onset colon and rectum cancer (E) worldwide in 21 GBD and 5 SDI regions, 2019.
FIGURE 4
FIGURE 4
Projected burden of global early‐onset digestive system malignancy, 2022–2030.
See this image and copyright information in PMC

References

    1. Arnold M., Abnet C. C., Neale R. E., et al., “Global Burden of 5 Major Types of Gastrointestinal Cancer,” Gastroenterology 159 (2020): 335–349.e315. - PMC - PubMed
    1. Ferlay J., Ervik M., Lam F., et al., “Global Cancer Observatory: Cancer Today,” (2020), 20182020.
    1. Ugai T., Sasamoto N., Lee H. Y., et al., “Is Early‐Onset Cancer an Emerging Global Epidemic? Current Evidence and Future Implications,” Nature Reviews. Clinical Oncology 19 (2022): 656–673. - PMC - PubMed
    1. Koh B., Tan D. J. H., Ng C. H., et al., “Patterns in Cancer Incidence Among People Younger Than 50 Years in the US, 2010 to 2019,” JAMA Network Open 6 (2023): e2328171. - PMC - PubMed
    1. Barreto S. G. and Pandol S. J., “Young‐Onset Carcinogenesis – The Potential Impact of Perinatal and Early Life Metabolic Influences on the Epigenome,” Frontiers in Oncology 11 (2021): 653289. - PMC - PubMed

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