Trends in incidence and mortality of early-onset gastrointestinal cancers: a comprehensive study

BMC Gastroenterol. 2025 Jun 2;25(1):424. doi: 10.1186/s12876-025-04015-6.

Abstract

Background: Early-Onset Gastrointestinal Cancers concerns tumors in people under 50. Accumulating evidence suggests a significant increase in the burden of colorectal cancer in young adults. We investigated the global burden and spatiotemporal trends of the 6 major gastrointestinal (GI) cancers, including colon and rectum cancer (CRC), esophageal cancer (EC), gallbladder and biliary tract cancer (GBTC), liver cancer (LC), pancreatic cancer (PC), and stomach cancer (SC). in young adults, based on cancer-specific incidence and mortality.

Methods: All data for 6 early-onset (EO) GI cancers were obtained from the Global Burden of Disease study. Age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and corresponding estimated annual percentage change (EAPC) were calculated to assess temporal trends from 1990 to 2019.

Results: The global number of cases and deaths from all EO-GI cancers has risen since 1990, reaching 539,750 and 309,200, respectively in 2019. ASIR and ASDR decreased for most EO-GI cancers (total, esophageal, gallbladder and biliary tract (GBTC), liver, and stomach cancers), while EO-pancreatic cancer showed an upward trend. EO colorectal cancer had increased incidence and stable mortality. However, these trends varied by sex, age, region, and economic status. Men had a higher burden of EO GI cancers (except GBTC), and older populations were more affected. Asia, particularly East Asia, had a significant burden, while the Americas showed the largest increase. Areas with Middle and High-middle sociodemographic indices had a relatively high burden of EO-GI cancers.

Conclusions: The absolute burden of EO-GI cancers is rising worldwide, but the standardized burden has decreased, This indicates that we have made considerable progress in treatment and early detection.

Keywords: Early-onset Gastrointestinal cancer; Epidemiology; Global burden of disease; Incidence; Mortality.

MeSH terms

  • Adult
  • Age of Onset
  • Biliary Tract Neoplasms / epidemiology
  • Biliary Tract Neoplasms / mortality
  • Esophageal Neoplasms / epidemiology
  • Esophageal Neoplasms / mortality
  • Female
  • Gallbladder Neoplasms / epidemiology
  • Gallbladder Neoplasms / mortality
  • Gastrointestinal Neoplasms* / epidemiology
  • Gastrointestinal Neoplasms* / mortality
  • Global Burden of Disease / trends
  • Global Health / statistics & numerical data
  • Humans
  • Incidence
  • Liver Neoplasms / epidemiology
  • Liver Neoplasms / mortality
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / epidemiology
  • Pancreatic Neoplasms / mortality
  • Stomach Neoplasms / epidemiology
  • Stomach Neoplasms / mortality
  • Young Adult