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GI cancer
Original research
Epidemiology of gastrointestinal cancers: a systematic analysis from the Global Burden of Disease Study 2021
  1. Pojsakorn Danpanichkul1,
  2. Kanokphong Suparan2,
  3. Primrose Tothanarungroj3,
  4. Disatorn Dejvajara3,
  5. Krittameth Rakwong3,
  6. Yanfang Pang2,4,5,6,
  7. Romelia Barba1,
  8. Jerapas Thongpiya1,
  9. Michael B Fallon7,8,
  10. Denise Harnois9,
  11. Rashid N Lui10,
  12. Michael B Wallace9,
  13. Ju Dong Yang11,
  14. Lewis R Roberts12,
  15. Karn Wijarnpreecha7,8,13
  1. 1Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
  2. 2Department of Microbiology, Chiang Mai University, Chiang Mai, Thailand
  3. 3Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  4. 4Affiliated Hospital of Youjiang Medical University of Nationalities, Baise, Guangxi, People's Republic of China
  5. 5National Immunological Laboratory for Traditional Chinese Medicine, Baise, Guangxi, People's Republic of China
  6. 6Key Laboratory of Research on Clinical Molecular Diagnosis for High Incidence Diseases in Western Guangxi, Guangxi, Guangxi, People's Republic of China
  7. 7Division of Gastroenterology and Hepatology, Department of Medicine, The University of Arizona College of Medicine Phoenix, Phoenix, Arizona, USA
  8. 8Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner - University Medical Center Phoenix, Phoenix, Arizona, USA
  9. 9Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
  10. 10Institute of Digestive Disease, Chinese University of Hong Kong, New Territories, Hong Kong, People's Republic of China
  11. 11Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, and Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
  12. 12Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
  13. 13Mayo Clinic Florida, Jacksonville, Florida, USA
  1. Correspondence to Dr Pojsakorn Danpanichkul, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, Thailand; pojsakorndan{at}gmail.com; Dr Karn Wijarnpreecha; dr.karn.wi{at}gmail.com

Abstract

Background Gastrointestinal cancers comprise nearly one-third of global mortality from cancer, yet the comprehensive global burden of these cancers remains uninvestigated.

Objective We aimed to assess the global, regional and national burden of gastrointestinal cancers.

Designs 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).

Results 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.

Conclusions 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.

  • CANCER
  • COLORECTAL CANCER
  • EPIDEMIOLOGY
  • ALCOHOLIC LIVER DISEASE
  • NONALCOHOLIC STEATOHEPATITIS

Data availability statement

Data are available in a public, open access repository. Data from the Global Burden of Disease (GBD) study in 2021 can be accessed using the Global Health Data Exchange (GHDx) query tool (http://ghdx.healthdata.org/gbd-results-tool) which the Institute for Health Metrics and Evaluation maintains. The GBD data do not require licensing for non-commercial use.

https://doi.org/10.1136/gutjnl-2024-333227

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    Data availability statement

    Data are available in a public, open access repository. Data from the Global Burden of Disease (GBD) study in 2021 can be accessed using the Global Health Data Exchange (GHDx) query tool (http://ghdx.healthdata.org/gbd-results-tool) which the Institute for Health Metrics and Evaluation maintains. The GBD data do not require licensing for non-commercial use.

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    Footnotes

    • PD and KS are joint first authors.

    • LRR and KW are joint senior authors.

    • X @RashidLui, @KarnJUVE

    • Contributors Guarantor of the article—PD. Conceptualisation—PD, KW, JDY. Data curation—PD, KS, RB. Formal analysis—PD, RB, YP. Investigation—PD, JT, KR. Methodology—PD, JT, KR. Project administration—PD, KW, MBW, JDY. Supervision—KW, MBW, MBF, JDY. Validation—PD, PT, KR, DD. Visualisation—PD, DD, JT. Writing, original draft—PD, PT, KS. Writing, review and editing—PD, KW, RNL, JDY, DH, LRR, MBF. All authors have read and approved the final version of the manuscript for submission.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Map disclaimer The depiction of boundaries on this map does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. This map is provided without any warranty of any kind, either express or implied.

    • Competing interests MBW declared the conflict of interest as designated below: Consulting: Cosmo/Aries Pharmaceuticals, Verily, Boston Scientific, Endiatix, Intervenn, AlphaMed UAE, Fujifilm. Research grants: Fujifilm, Boston Scientific, Olympus, Medtronic, Ninepoint Medical, Cosmo/Aries Pharmaceuticals. Stock/Stock Options: Virgo Inc. Consulting on behalf of Mayo Clinic: Boston Scientific, Microtek. General payments/Minor Food and Beverage: Boston Scientific and Cook Medical. All other coauthors denied conflict of interest. LRR has been on advisory boards for AstraZeneca, Bayer, Eisai, Exact Sciences, Focus Medical Communication, Gilead Sciences, GRAIL, Inc., Novartis Venture Fund, Pontifax, and Roche. LR has received research support from Bayer, Boston Scientific, Exact Sciences, Fujifilm Medical Systems, Genentech, Gilead Sciences, Glycotest, Inc., HERMES, Innovo Bioanalysis, RedHill Biopharma, and TARGET Real World Evidence.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.