Disease Burden of Gastrointestinal Tumors in China From 1990 to 2021, an Analysis for the Global Burden of Disease Study 2021

IF 3.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of Evidence‐Based Medicine Pub Date : 2025-09-20 DOI:10.1111/jebm.70072

Lanwei Guo, Jiani Yuan, Lin Cai, Chenxin Zhu, Yan Zheng, Haiyan Yang, Yanyan Liu

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引用次数: 0

Abstract

Objective

China faces a significant burden of gastrointestinal tumors driven by socioeconomic, environmental, and lifestyle factors. Using GBD2021 data, this study analyses epidemiological trends and disease burden for six major gastrointestinal tumor cancers (esophagus, gastric, colorectum, liver, pancreas, gallbladder and biliary tract) in China (1990–2021).

Methods

The GBD 2021 was used to extract the incidence, mortality, and disability-adjusted life years (DALYs) data of gastrointestinal tumors in China. Age-standardized rates (ASRs) and 95% uncertainty intervals (UIs) were calculated. Temporal trends were assessed by joinpoint regression analysis, and average annual percent change (AAPC) and annual percentage change (APC) were calculated and analyzed stratified by gender and age group.

Results

In 2021, China recorded 1.96 million new gastrointestinal cancer cases, with 1.35 million deaths and 33.07 million DALYs. Gastric cancer led in mortality, and colorectal cancer demonstrated the most rapid incidence growth (AAPC = 1.68). Significant reductions were observed in gastric cancer age-standardized mortality rates (ASMR) (AAPC = –2.44) and esophageal cancer age-standardized disability-adjusted life year rates (ASDR) (AAPC = –2.31). Gender disparities were particularly pronounced in esophageal cancer, with the male-to-female mortality ratio (M/F) escalating from 2.50 (1990) to 4.12 (2021). The age group with the highest mortality burden was 70–74, while the age group with the most significant loss of DALYs was 65–69.

Conclusion

China has significantly reduced gastrointestinal cancer burden, but gender and age disparities persist, necessitating targeted interventions. Future efforts should focus on tertiary prevention for high-risk groups, especially males and the elderly, while enhancing molecular subtyping and regional data stratification for precision cancer control.

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1990 - 2021年中国胃肠道肿瘤疾病负担——2021年全球疾病负担研究分析

目的：受社会经济、环境和生活方式等因素的影响，中国面临着显著的胃肠道肿瘤负担。本研究采用GBD2021数据，分析1990-2021年中国六大胃肠道肿瘤（食道、胃、结直肠、肝、胰腺、胆囊和胆道）的流行趋势和疾病负担。方法：采用GBD 2021提取中国胃肠道肿瘤的发病率、死亡率和伤残调整生命年（DALYs）数据。计算年龄标准化率（ASRs）和95%不确定区间（UIs）。采用连接点回归分析评估时间趋势，按性别和年龄分层计算平均年变化百分比（AAPC）和年变化百分比（APC）。结果：2021年，中国新增胃肠道肿瘤病例196万例，死亡135万例，DALYs 3307万例。胃癌死亡率最高，结直肠癌发病率增长最快（AAPC = 1.68）。胃癌年龄标准化死亡率（ASMR）（AAPC = -2.44）和食管癌年龄标准化残疾调整生命年率（ASDR）（AAPC = -2.31）均有显著降低。性别差异在食管癌中尤为明显，男女死亡率（M/F）从2.50（1990年）上升到4.12（2021年）。死亡负担最高的年龄组为70-74岁，而残疾调整生命年损失最显著的年龄组为65-69岁。结论：中国胃肠道肿瘤负担显著减轻，但性别和年龄差异仍然存在，需要有针对性的干预措施。未来的工作应侧重于高危人群的三级预防，特别是男性和老年人，同时加强分子分型和区域数据分层，以实现精确的癌症控制。

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来源期刊

Journal of Evidence‐Based Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

11.20

自引率

1.40%

发文量

期刊介绍： The Journal of Evidence-Based Medicine (EMB) is an esteemed international healthcare and medical decision-making journal, dedicated to publishing groundbreaking research outcomes in evidence-based decision-making, research, practice, and education. Serving as the official English-language journal of the Cochrane China Centre and West China Hospital of Sichuan University, we eagerly welcome editorials, commentaries, and systematic reviews encompassing various topics such as clinical trials, policy, drug and patient safety, education, and knowledge translation.