Global Burden and Trends of Early-Onset Gastrointestinal Cancers From 1990 to 2021

Abstract

Objective: We aimed to explore the global burden and trends of early-onset gastrointestinal (GI) cancers, defined as those diagnosed in individuals younger than 50 years of age, from 1990 to 2021 based on the Global Burden of Disease Study 2021 (GBD 2021).

Methods: Data of disability-adjusted life-years (DALYs), incidence, and corresponding age-standardized rates were extracted to assess the burden and trends of early-onset GI cancers, including esophageal, gastric, liver, colorectal, pancreatic, and gallbladder and biliary tract cancers from 1990 to 2021.

Results: Colorectal cancer had the highest age-standardized DALYs rate (ASDR) and incidence rate (ASIR) globally at 101.37 and 5.37 per 100 000 in 2021. Moreover, it showed the greatest ASIR growth over the past three decades, with projections indicating it would remain the leading cause by 2040. Colorectal, gastric, and liver cancers ranked the top three contributors to disease burden in 2021, with gastric cancer showing the most significant decline (average annual percentage change [AAPC] for ASDR: −2.27; for ASIR: −1.71). Elevated body mass index was the risk factor for most of these cancers, with AAPC ranging from 0.68 to 5.09. Additionally, early-onset pancreatic cancer had the greatest impact in Eastern Europe, while gallbladder and biliary tract cancer was more prevalent in Southern Latin America. East Asia had the heaviest burden of other cancers.

Conclusions: Early-onset colorectal, gastric, and liver cancers were the top three contributors to disease burden in 2021. Preventing these cancers and reducing obesity should be the main priorities for public health.

Keywords

early onset / epidemiology / gastrointestinal neoplasms / global burden of disease / risk factor

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2026 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.