Clinical and Translational Research
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2024; 16(9): 3955-3979
Published online Sep 15, 2024. doi: 10.4251/wjgo.v16.i9.3955
Burden of gastrointestinal cancers among working-age population over past thirty years in China
Yu Dong, Zhuan-Zhuan Fan, Wen-Ting Li, Jian Kang, Yan Zhang, Yue Guan, Hui-Qing Xu, Jie Yuan, Fei Xu
Yu Dong, Yan Zhang, Yue Guan, Jie Yuan, Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China
Zhuan-Zhuan Fan, Wen-Ting Li, Fei Xu, Department of Primary Healthcare Management, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, Jiangsu Province, China
Jian Kang, Department of Emergency, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Hui-Qing Xu, Fei Xu, Department of Epidemiology, Nanjing Medical University School of Public Health, Nanjing 211116, Jiangsu Province, China
Co-first authors: Yu Dong and Zhuan-Zhuan Fan.
Co-corresponding authors: Jie Yuan and Fei Xu.
Author contributions: Yuan J and Xu F conceived, designed and supervised the study, they are the co-corresponding authors of this manuscript; Dong Y and Fan ZZ were responsible for data acquisition, and they contributed equally to this manuscript; Fan ZZ was responsible for data analysis; Dong Y, Fan ZZ, Li WT, Kang J, Zhang Y, Guan Y, Xu HQ, Yuan J, and Xu F wrote and critically reviewed the manuscript. All authors approved the final version for submission and was also responsible for all aspects of the work presented in this manuscript.
Supported by Nanjing Medical Science and Technique Development Foundation, No. YKK22195; and the National Natural Science Foundation of China, No. 52078254.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fei Xu, PhD, Professor, Department of Primary Healthcare Management, Nanjing Municipal Center for Disease Control and Prevention, No. 3 Zizhulin, Nanjing 210003, Jiangsu Province, China. frankxufei@163.com
Received: June 27, 2024
Revised: July 15, 2024
Accepted: August 7, 2024
Published online: September 15, 2024
Processing time: 73 Days and 22.5 Hours
Abstract
BACKGROUND

Although gastrointestinal (GI) cancers have been becoming a great public health concern in China, there is currently a lack of comprehensive literature on the overall burden and changing trends of GI cancers in the working-age population.

AIM

To assess the burden of GI cancers and to examine the overall, age- and gender-specific trends among the working-age population in China from 1990 to 2019.

METHODS

Data were extracted from the Global Burden of Disease Study 2019. The burden of GI cancers was indicated by incidence, mortality, disability-adjusted life-years (DALYs), age-standardized incidence rate (ASIR), age-standardized mortality rate, and age-standardized DALYs rate. Trends in the burden of GI cancers from 1990 to 2019 were examined using annual percent change and average annual percent change with Joinpoint regression models.

RESULTS

For overall GI cancers, a declining trend was observed in the ASIR, age-standardized mortality rate, and age-standardized DALYs rate, with reductions of 0.74%, 2.23%, and 2.22%, respectively, from 1999 to 2019 in the Chinese working-age population. However, an increasing trend was observed in the ASIR for overall GI cancers from 2016-2019. The number of either incident cases, mortality cases, and DALYs was higher for colon/rectum cancer and liver cancer in younger participants but lower for esophageal, gallbladder, biliary tract, pancreatic, and stomach cancer among older subjects. Moreover, sex disparity in the GI cancers burden was also examined over 30 years.

CONCLUSION

The total burden of GI cancers remained heavy among the working-age population in China, although declining trends were observed from 1999 to 2019. Disparities in the GI cancers burden existed between sexes, age groups, and cancer types. Population-based precision prevention strategies are needed to tackle GI cancers among working-age individuals, considering the age, sex, and cancer type disparities in China.

Keywords: Gastrointestinal cancer; Working-age population; Disease burden; Disability-adjusted life-years; Chinese

Core Tip: This is the first study that systematically assessed total burden of gastrointestinal (GI) cancers among the working-age population in China. It was observed that GI cancers burden remained much heavy among working-age population, although declining trends in burden of GI cancers were examined from 1990 to 2019 in China. Moreover, substantial disparities in burden of GI cancers existed between genders, age-groups and cancer types. This study has important public health implications that precision prevention policies and strategies are needed for tackling GI cancers among working-age people with consideration of age-, gender- and type-specific effective and accessible approaches in China.