Nationwide Trends and Projections of Early Onset Gastrointestinal Cancers in China
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Authors to whom correspondence should be addressed.
Cancers 2025, 17(18), 2954; https://doi.org/10.3390/cancers17182954
Submission received: 4 August 2025
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Revised: 2 September 2025
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Accepted: 8 September 2025
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Published: 9 September 2025
(This article belongs to the Special Issue Gastrointestinal Malignancy: Epidemiology and Risk Factors)
Simple Summary
Early-onset gastrointestinal cancers have emerged as a significant health challenge in China. This study analyzed national data for individuals aged 15–49 years from 1990 to 2021. We found substantial declines in stomach, esophageal, and liver cancers, contrasted with rising trends in colorectal, biliary tract, and pancreatic cancers. Projections through 2040 indicate further increases in colorectal and biliary cancers, with the age-standardized incidence rate of pancreatic cancer expected to peak around 2030. These divergent trajectories highlight the need to adapt prevention, screening, and early detection strategies to early-onset populations. By characterizing site-specific patterns and forecasting future burdens, our findings provide an evidence base to guide public health policy, optimize clinical management, and improve cancer control among individuals affected at younger ages.
Abstract
Early-onset (15–49 years) gastrointestinal cancers are an emerging public health concern in China, yet national trend analyses remain limited. Drawing on data from the Global Burden of Disease 2021 study, we evaluated nationwide trends in the incidence and mortality of early-onset gastrointestinal cancers (esophagus, stomach, liver, colon and rectum, gallbladder and biliary tract, and pancreas) in China from 1990 to 2021 and projected future patterns through 2040 using Bayesian age–period–cohort models. Between 1990 and 2021, age-standardized rates for esophageal, stomach, and liver cancers declined markedly while those for colorectal and biliary tract cancers increased, and pancreatic cancer rates rose modestly. Mortality for upper-GI cancers fell substantially, whereas colorectal cancer deaths rose modestly, with the age-standardized mortality rate declining despite rising incidence. Projections suggest continued declines in upper-GI cancers, further increases in colorectal and biliary tract cancers, and a peak in the age-standardized incidence rate of pancreatic cancer around 2030. These divergent trends highlight an urgent need for targeted prevention and early-detection strategies focused on colorectal, biliary, and pancreatic cancers among patients aged 15–49 years in China.
