Incidence Trends and Projections of Major Gastrointestinal Cancers in the United States: A SEER-Based Analysis from 2000 to 2022.

BACKGROUND

Gastrointestinal (GI) cancers account for a substantial cancer burden, yet contemporary incidence trends and future projections across cancer sites and demographic subgroups remain incompletely characterized. We aimed to analyze incidence trends from 2000-2022 and forecast rates through 2032 for eight major GI cancers in the United States.

METHODS

Using SEER Research Data (17 registries, 2000-2022), we identified patients with esophageal, gastric, liver, gallbladder, pancreatic, small intestine, and colorectal cancer. Age-adjusted incidence rates were calculated and stratified by sex, age group (<60 vs. ≥60 years), and race (White, Black, Asian/Pacific Islander, American Indian/Alaska Native). Time-series forecasting models (linear regression, ARIMA, ETS, NNAR) were applied to project incidence through 2032.

RESULTS

Incidence trends varied markedly by cancer site. Pancreatic cancer showed sustained increases across most subgroups, with projected rates rising from 4.41 to 5.11 per 100,000 by 2032. Colorectal cancer demonstrated divergent age-specific patterns: incidence among individuals ≥60 years is projected to decline (25.48 to 14.89 per 100,000), while early-onset disease (<60 years) is expected to increase (5.35 to 5.84 per 100,000). Liver cancer incidence is forecast to decline (2.18 to 1.42 per 100,000). Esophageal and gastric cancers showed modest increases, while gallbladder cancer remained stable. Substantial disparities persisted by sex (male predominance for most sites, female predominance for gallbladder) and race (highest burden among Asian/Pacific Islander populations).

CONCLUSIONS

GI cancer incidence trajectories are highly heterogeneous. The projected rise in pancreatic and early-onset colorectal cancers signals urgent needs for targeted prevention, risk-factor modification, and improved early detection strategies in at-risk populations.