Time-space analysis of gastrointestinal cancers among the working-age individuals in Brazil, Russia, India, China, and South Africa (BRICS)-plus countries (1990-2021): a comprehensive analysis from the Global Burden of Disease Study 2021

Abstract

Background: Gastrointestinal (GI) cancers remain a major public health concern worldwide. However, limited evidence exists on the burden and trends of these cancers among the economically active population in BRICS-plus countries, including Brazil, Russia, India, China, South Africa, Egypt, Ethiopia, Iran, Saudi Arabia, and the United Arab Emirates. This study aimed to assess the long-term patterns and current status of 6 major GI cancers among working-age adults (20-64 years) across these countries between 1990 and 2021.

Methods: This study used data from the Global Burden of Disease Study 2021 to analyze disability-adjusted life years (DALYs) related to 6 GI cancers: colorectal, esophageal, stomach, liver, gallbladder and biliary tract, and pancreatic cancers. Trends in age-standardized DALY rates (ASDRs) were evaluated over time, and changes in DALYs were further examined using decomposition analysis to identify contributions from population growth, aging, and changes in disease prevalence and severity.

Results: In 2021, China had the highest ASDRs of GI cancers among BRICS-plus countries, contributing more than 17 million DALYs. Of note, 4 cancers (colorectal, esophageal, stomach, and liver) together accounted for more than 70% of the total GI cancer burden between 1990 and 2021. Although the overall number of DALYs increased in most countries, largely due to population growth, the ASDRs decreased in most BRICS-plus countries, except Egypt. Reductions were most pronounced in patients with esophageal and stomach cancers. Men had a higher burden for most GI cancers than women, except for gallbladder and biliary tract cancers, in which women were more affected. The highest burden was observed in individuals aged 60 to 64 years.

Conclusion: GI cancers place a substantial and growing burden on the working-age population in BRICS-plus countries. Substantial disparities in cancer burden were observed across time, age, sex, and country, highlighting the urgent need for tailored public health strategies.

Keywords: BRICS(Brazil, Russia, India, China and South Africa); Disability-adjusted life years; Estimating annual percentage change; Gastrointestinal cancer; Global Burden of Disease.