Background:Gastrointestinal(GI)cancers were responsible for 26.3%of cancer cases and 35.4%of deaths worldwide in 2018.This study aimed to analyze the global incidence,mortality,prevalence,and contributing risk factors...Background:Gastrointestinal(GI)cancers were responsible for 26.3%of cancer cases and 35.4%of deaths worldwide in 2018.This study aimed to analyze the global incidence,mortality,prevalence,and contributing risk factors of the 6 major GI cancer entities[esophageal cancer(EC),gastric cancer(GC),liver cancer(LC),pancreatic cancer(PC),colon cancer,and rectal cancer].Methods:Using the Global Cancer Observatory and the Global Health Observatory databases,we reviewed the current GI cancer incidence,prevalence,and mortality,analyzed the association of GI cancer prevalence with national human development indices(HDIs),identified the contributing risk factors,and estimated developing age-and sex-specific trends in incidence and mortality.Results:In 2020,the trend in age-standardized rate of incidence of GI cancers closely mirrored that of mortality,with the highest rates of LC,EC,and GC in Asia and of colorectal cancer(CRC)and PC mainly in Europe.Incidence and mortality were positively,but the mortality-to-incidence ratio(MIR)was inversely correlated with the national HDI levels.High MIRs in developing countries likely reflected the lack of preventive strategies and effective treatments.GI cancer prevalence was highest in Europe and was also positively correlated with HDIs and lifestyle-associated risk factors,such as alcohol consumption,smoking,obesity,insufficient physical activity,and high blood cholesterol level,but negatively correlated with hypertension and diabetes.Incidences of EC were consistently and those of GC mostly decreasing,whereas incidences of CRC were increasing in most countries/regions,especially in the younger populations.Incidences of LC and PC were also increasing in all age-gender populations except for younger males.Mortalities were decreasing for EC,GC,and CRC in most countries/regions, and age-specific trends were observed in PC and LC with adecrease in the younger but an increase in the older population.Conclusions: On the global scale, higher GI cancer burden was accompanied,for the most part, by factors associated with the so-called Western lifestylereflected by high and very high national HDI levels. In countries/regionswith very high HDI levels, patients survived longer, and increasing GI cancercases were observed with increasing national HDI levels. Optimizing GI cancer prevention and improving therapies, especially for patients with comorbidmetabolic diseases, are thus urgently recommended.展开更多
文摘背景与目的2018年,胃肠道(gastrointestinal,GI)癌症占全球癌症病例的26.3%和癌症死亡人数的35.4%。本研究旨在分析全球6种主要胃肠道癌症:食道癌(esophageal cancer,EC)、胃癌(gastric cancer,GC)、肝癌(liver cancer,LC)、胰腺癌(pancreatic cancer,PC)、结肠癌(colon cancer,CC)和直肠癌(rectal cancer,RC)的发病率、死亡率、患病率和致病风险因素。方法我们使用全球癌症观察站(Global Cancer Observatory,GCO)和全球卫生观察站(Global Health Observatory,GHO)数据库,回顾当前的GI癌症发病率、患病率和死亡率,分析GI癌症患病率与国家的人类发展指数(human development indices,HDI)的相关性,确定致病风险因素,估计不同年龄和性别人群的发病率和死亡率的发展趋势。结果2020年,GI癌症年龄标化发病率趋势与死亡率密切相关,LC、EC和GC的发病率在亚洲最高,结直肠癌(colorectal cancer,CRC)和PC的发病率在欧洲较高。发病率和死亡率呈正相关,而死亡发病比(mortalityto-incidence ratio,MIR)与国家HDI水平呈负相关。发展中国家的高MIR可能反映了预防战略和有效治疗的缺乏。GI癌症在欧洲较常见,与HDI和生活方式相关风险因素,如饮酒、吸烟、肥胖、运动不足和高血胆固醇水平等呈正相关,但与高血压和糖尿病呈负相关。在大多数国家/地区,EC的发病率一直在下降,GC的发病率也多呈下降趋势,而CRC的发病率却在上升,特别是在年轻人群中。除年轻男性外,LC和PC的发病率在所有年龄和性别的人群中也都在上升。在大多数国家/地区,EC、GC和CRC的死亡率都在下降,在PC和LC中观察到了年龄特定趋势:在年轻人口中减少,在老年人口中增加。结论在全球范围内,较高的GI癌症负担在很大程度上伴随着所谓的西方生活方式相关因素,这些因素反映了高和非常高的国家人类发展指数水平。在HDI非常高的国家/地区,患者生存时间更长,但随着国家HDI水平的提高,GI癌症患者也在增加。因此,我们建议优化GI癌症预防策略和改进治疗方案,尤其是对合并代谢性疾病的患者。
基金supported by the China Scholarship Council(grant number:201908080127).
文摘Background:Gastrointestinal(GI)cancers were responsible for 26.3%of cancer cases and 35.4%of deaths worldwide in 2018.This study aimed to analyze the global incidence,mortality,prevalence,and contributing risk factors of the 6 major GI cancer entities[esophageal cancer(EC),gastric cancer(GC),liver cancer(LC),pancreatic cancer(PC),colon cancer,and rectal cancer].Methods:Using the Global Cancer Observatory and the Global Health Observatory databases,we reviewed the current GI cancer incidence,prevalence,and mortality,analyzed the association of GI cancer prevalence with national human development indices(HDIs),identified the contributing risk factors,and estimated developing age-and sex-specific trends in incidence and mortality.Results:In 2020,the trend in age-standardized rate of incidence of GI cancers closely mirrored that of mortality,with the highest rates of LC,EC,and GC in Asia and of colorectal cancer(CRC)and PC mainly in Europe.Incidence and mortality were positively,but the mortality-to-incidence ratio(MIR)was inversely correlated with the national HDI levels.High MIRs in developing countries likely reflected the lack of preventive strategies and effective treatments.GI cancer prevalence was highest in Europe and was also positively correlated with HDIs and lifestyle-associated risk factors,such as alcohol consumption,smoking,obesity,insufficient physical activity,and high blood cholesterol level,but negatively correlated with hypertension and diabetes.Incidences of EC were consistently and those of GC mostly decreasing,whereas incidences of CRC were increasing in most countries/regions,especially in the younger populations.Incidences of LC and PC were also increasing in all age-gender populations except for younger males.Mortalities were decreasing for EC,GC,and CRC in most countries/regions, and age-specific trends were observed in PC and LC with adecrease in the younger but an increase in the older population.Conclusions: On the global scale, higher GI cancer burden was accompanied,for the most part, by factors associated with the so-called Western lifestylereflected by high and very high national HDI levels. In countries/regionswith very high HDI levels, patients survived longer, and increasing GI cancercases were observed with increasing national HDI levels. Optimizing GI cancer prevention and improving therapies, especially for patients with comorbidmetabolic diseases, are thus urgently recommended.
