Abstract：
OBJECTIVE: This study aimed to assess the burden of early-onset gastrointestinal (GI) cancers in China over three decades.
METHODS: A comprehensive analysis was performed using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.
METHODS: Data on early-onset GI cancers in 2020 and from 1990 to 2019 were extracted from GLOBOCAN 2020 database and GBD 2019, respectively. The average annual percent change (AAPC) was calculated to analyze the temporal trends using the Joinpoint Regression Program. The Bayesian age-period-cohort (BAPC) model was used to predict future trends up to 2030.
RESULTS: In China, there were 185,980 incident cases and 119,116 deaths of early-onset GI cancer in 2020, with the highest incidence and mortality observed in liver cancer (new cases: 71,662; deaths: 62,412). The spectrum of early-onset GI cancers in China has transitioned over the last 30 years. The age-standardized rates of incidence, mortality, and disability-adjusted life years for colorectal and pancreatic cancers exhibited rapid increases (AAPC >0, P ≤ 0.001). The fastest-growing incidence rate was found in colorectal cancer (AAPC: 3.06, P < 0.001). Despite the decreases in liver, gastric, and esophageal cancers, these trends have been reversed or flattened in recent years. High body mass index was found to be the fastest-growing risk factor for early-onset GI cancers (estimated annual percentage change: 2.75-4.19, P < 0.05). Projection analyses showed an increasing trend in age-standardized incidence rates for almost all early-onset GI cancers during 2020-2030.
CONCLUSIONS: The transitioning pattern of early-onset GI cancers in China emphasizes the urgency of addressing this public health challenge.
METHODS: A comprehensive analysis was performed using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.
METHODS: Data on early-onset GI cancers in 2020 and from 1990 to 2019 were extracted from GLOBOCAN 2020 database and GBD 2019, respectively. The average annual percent change (AAPC) was calculated to analyze the temporal trends using the Joinpoint Regression Program. The Bayesian age-period-cohort (BAPC) model was used to predict future trends up to 2030.
RESULTS: In China, there were 185,980 incident cases and 119,116 deaths of early-onset GI cancer in 2020, with the highest incidence and mortality observed in liver cancer (new cases: 71,662; deaths: 62,412). The spectrum of early-onset GI cancers in China has transitioned over the last 30 years. The age-standardized rates of incidence, mortality, and disability-adjusted life years for colorectal and pancreatic cancers exhibited rapid increases (AAPC >0, P ≤ 0.001). The fastest-growing incidence rate was found in colorectal cancer (AAPC: 3.06, P < 0.001). Despite the decreases in liver, gastric, and esophageal cancers, these trends have been reversed or flattened in recent years. High body mass index was found to be the fastest-growing risk factor for early-onset GI cancers (estimated annual percentage change: 2.75-4.19, P < 0.05). Projection analyses showed an increasing trend in age-standardized incidence rates for almost all early-onset GI cancers during 2020-2030.
CONCLUSIONS: The transitioning pattern of early-onset GI cancers in China emphasizes the urgency of addressing this public health challenge.
摘要：
目的：本研究旨在评估中国早发性胃肠道（GI）癌症的负担。
方法：使用来自全球疾病负担的数据进行了全面分析，受伤,和风险因素研究（GBD）2019年。
方法：2020年和1990年至2019年的早发性胃肠道癌症数据分别从GLOBOCAN2020数据库和GBD2019中提取。使用Joinpoint回归程序计算平均年变化百分比（AAPC）以分析时间趋势。贝叶斯年龄周期队列（BAPC）模型用于预测2030年的未来趋势。
结果：在中国，在2020年,早发性胃肠道癌的发生率为185,980例,死亡119,116例,其中肝癌的发生率和死亡率最高(新病例:71,662例;死亡:62,412例).在过去的30年中，中国的早发性胃肠道癌症的范围发生了变化。年龄标准化的发病率，死亡率,结直肠癌和胰腺癌的残疾调整寿命年呈现快速增加(AAPC>0,P≤0.001)。结直肠癌发病率增长最快(AAPC:3.06,P<0.001)。尽管肝脏减少，胃,和食道癌，近年来，这些趋势已经逆转或趋于平缓。发现高体重指数是早发性胃肠道癌症增长最快的危险因素（估计的年度变化百分比：2.75-4.19，P<0.05）。预测分析显示，在2020-2030年期间，几乎所有早发性胃肠道癌症的年龄标准化发病率都有增加的趋势。
结论：中国早发性胃肠道肿瘤的转变模式强调了应对这一公共卫生挑战的紧迫性。
方法：使用来自全球疾病负担的数据进行了全面分析，受伤,和风险因素研究（GBD）2019年。
方法：2020年和1990年至2019年的早发性胃肠道癌症数据分别从GLOBOCAN2020数据库和GBD2019中提取。使用Joinpoint回归程序计算平均年变化百分比（AAPC）以分析时间趋势。贝叶斯年龄周期队列（BAPC）模型用于预测2030年的未来趋势。
结果：在中国，在2020年,早发性胃肠道癌的发生率为185,980例,死亡119,116例,其中肝癌的发生率和死亡率最高(新病例:71,662例;死亡:62,412例).在过去的30年中，中国的早发性胃肠道癌症的范围发生了变化。年龄标准化的发病率，死亡率,结直肠癌和胰腺癌的残疾调整寿命年呈现快速增加(AAPC>0,P≤0.001)。结直肠癌发病率增长最快(AAPC:3.06,P<0.001)。尽管肝脏减少，胃,和食道癌，近年来，这些趋势已经逆转或趋于平缓。发现高体重指数是早发性胃肠道癌症增长最快的危险因素（估计的年度变化百分比：2.75-4.19，P<0.05）。预测分析显示，在2020-2030年期间，几乎所有早发性胃肠道癌症的年龄标准化发病率都有增加的趋势。
结论：中国早发性胃肠道肿瘤的转变模式强调了应对这一公共卫生挑战的紧迫性。
