Trends in premature mortality from digestive system cancers in Slovakia in the years 2011–2020: 8 diagnoses over 10 years

Introduction and objectives: Slovakia ranks among the leaders in preventable deaths, but a systematic analysis of the share of digestive system cancers (DSCs) and their trends has been lacking. We analyzed data on mortality from DSCs in Slovakia in the years 2011–2020 with an emphasis on premature deaths, sex differences, and trends for individual locations. Material and methods: Data in the years 2011–2020 by ICD-10 codes C15–C26 aggregated by age subgroups (<50 years, <65 years, <75 years), sex, and individual locations were available. The crude death rate was calculated per 100,000 inhabitants and linear regression was used for the annual percentage change in mortality. Results: We recorded 46,508 deaths; 27,146 were men and 19,362 women with an average age of 70,5 ±11,6. Deaths under the age of 50, 65, and 75 made up 4.1%, 29.8%, and 60.4% of all deaths from DSCs. Among all deaths due to cancer under the age of 65, deaths from DSCs accounted for one-third in men and one-quarter in women. Under the age of 75, colorectal (41%), pancreatic (21%), stomach (12.8%), and liver (10%) cancers dominated the proportions of locations. The average age of death was significantly lower in men and increased over the decade for all locations. In women, the trend was identical, except for the liver, intrahepatic bile ducts (decrease by 1 year), bile ducts, and stomach (no change). Under the age of 65 in all cases, the average annual mortality rate decreased by 1.7%. In men, it decreased for locations in the esophagus, stomach, colorectum (–1.8%/year), liver, and gallbladder. In women, for colorectum (–1.8%/year) and gallbladder (–6%/year). In contrast, in the entire population mortality increased for locations in the pancreas (+2.3 to 2.8%/year) and bile ducts (+4.4 to 7.3%/year). Conclusion: DSCs are significant burden causing preventable deaths. Some favorable trends (stomach, gall bladder) are simultaneously followed by unfavorable ones (biliary tract, pancreas). In the global context of an aging population and increasingly longer exposure to risk factors, we need to introduce effective societal preventive measures as well as flexible adaptation of our healthcare systems.