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

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.