Global Burden and Future Trends of Gastrointestinal Cancers in Adolescents and Young Adults, 1990-2045: A Predictive Analysis.

PURPOSE: Gastrointestinal (GI) cancers significantly contribute to the global cancer burden, yet their epidemiological trends among adolescents and young adults (AYAs: aged 15-39 years) remain understudied. This study provides the first comprehensive analysis of global burden, temporal trends (1990-2021), and projections to 2045 for GI cancers in AYAs.

METHODS

Using the Global Burden of Disease (GBD) 2021 dataset, we analyzed age-standardized incidence rates (ASIR), death rates (ASDR), disability-adjusted life-years (DALYs), and estimated annual percentage changes (EAPC). Bayesian age-period-cohort modeling was employed for projections to 2045.

RESULTS

In 2021, there were 156,033 new GI cancer cases, 84,623 deaths, and 4.9 million DALYs among AYAs globally. From 1990 to 2021, ASIR for colorectal and gallbladder cancers increased (EAPCs:0.55[95%CI:0.44, 0.67] and 0.13[0.05, 0.20], respectively), while ASIR for other GI cancers declined (e.g., stomach cancer:-2.75 [- 2.94, - 2.57]). East Asia bore the highest burden. Projections suggest a stabilization of overall ASIR and ASDR by 2045, though liver and gallbladder cancers are expected to rise.

CONCLUSIONS

The burden of GI cancers among AYAs remains substantial and is projected to persist, highlighting the need for targeted early-detection strategies and age-specific prevention programs, especially in high-risk regions.