Burdens of stomach and esophageal cancer from 1990 to 2019 and projection to 2030 in China: Findings from the 2019 Global Burden of Disease Study

Opioid analgesics for sedation-based gastrointestinal endoscopy

Gastrointestinal endoscopy is a common examination for digestive system. The stimulation of endoscope often causes cough, nausea and vomiting, increased heart rate and blood pressure, arrhythmia, and even cardiovascular and cerebrovascular accidents, thus makes people fear of this procedure. Sedation or anesthesia can effectively improve the safety, comfort and quality of gastrointestinal endoscopy. A small dose of opioids is a good adjuvant to sedatives. In this narrative review, we summarized the main roles of opioid analgesics in gastrointestinal endoscopy, including reducing visceral pain, throat irritation and the dose of sedatives. Moreover, the frequently used and novel opioids are reviewed. Classic fentanyl, sufentanil and dezocine are preferable by anesthesiologists. Newly approved oliceridine is promising to render ideal analgesic effects for gastrointestinal endoscopy. Clinical studies on oliceridine in endoscopic procedures are urgently needed.

Effect of tristetraprolin on esophageal squamous cell carcinoma cell proliferation

BACKGROUND

Tristetraprolin (TTP) can inhibit the abnormal proliferation of malignant tumors but there are no studies involving TTP and esophageal squamous cell carcinoma (ESCC). We aimed to determine the effect of TTP on ESCC cell proliferation and to elucidate the underlying mechanism.

METHODS

The human ESCC cell line, KYSE-510, and the human ESCC cell line, KYSE-150, stably infected with tetracycline-inducible expression (Tet-on-TTP and Tet-on-EV, respectively) were screened with puromycin. After Tet-on-TTP KYSE-150 cells were treated with different concentrations of doxycycline [Dox] (0, 0.5, and 1 ug/mL), the levels of TTP mRNA and protein expression were detected by real-time fluorescent quantitative PCR and western blotting, respectively. The effects of TTP on proliferation and migration were estimated by CCK-8 and Transwell assays, respectively. Cell apoptosis and cell cycle were measured by flow cytometry. Cellular apoptosis-related gene protein expression was determined by western blotting.

RESULTS

TTP overexpression significantly inhibited KYSE-510 and KYSE-150 proliferation. TTP overexpression also significantly inhibited KYSE-150 migration. In addition, TTP expression upregulation promoted the KYSE-150 apoptosis and induced cell cycle arrest in the G2 phase, downregulated Bcl-2 expression, and upregulated Bax expression.

CONCLUSION

TTP inhibited ESCC cell proliferation, promoted ESCC cell apoptosis, and arrested cell cycle progression in the G2 phase.

Impact of preoperative comorbidities on elderly patients with esophageal squamous cell carcinoma following esophagectomy: a propensity score matching analysis

OBJECTIVE

Elderly patients, particularly those aged 70 and above, often present with comorbidities such as coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM), and high blood pressure (HBP). These comorbid diseases complicate treatment. However, the impact of these comorbidities on survival outcomes and complications in elderly patients undergoing esophagectomy for esophageal squamous cell carcinoma (ESCC) remains under-researched.

METHODS

This cohort study examined ESCC patients aged 70 and older who underwent esophagectomy. Patients were divided into two cohorts: those without preoperative comorbid diseases (NCD group) and those with preoperative comorbid diseases (CD group). Data were obtained from the Sichuan Cancer Hospital and Institute Esophageal Cancer Case Management Database between May 2016 and August 2021, with follow-up concluding on December 20, 2023.

RESULTS

A total of 469 patients met the inclusion criteria, with 206 patients in the comorbid diseases (CD group) and 263 patients without (NCD group). The median follow-up period was 47.5 months, the median overall survival (OS) was 51.6 months and median disease-free survival (DFS) was 33.0 months, with no statistically significant difference in OS and DFS in 2 groups. The incidence of grade 3 or higher complications in the NCD and CD groups was similar, with no statistically significant difference. The most common grade 3 or higher complications were pulmonary infection, hydrothorax, anastomotic stenosis, and anastomotic leakage.

CONCLUSIONS

Preoperative comorbidities, including CHD, COPD, DM, and HBP, did not significantly impact the long-term survival or disease-free survival of elderly ESCC patients undergoing esophagectomy.

Global, Regional and National Burden of Stomach Cancer and Its Prediction in 25 Years: A Cross-Sectional Study of the Global Burden of Disease Study 2021

Aims/Background Given the tremendous threat of stomach cancer (SC) to global public health, detailed information and dynamic updates on the SC health burden are needed to mitigate the repercussions. In this article, we present a systematic analysis of the global burden and trends of SC using data from the Global Burden of Disease (GBD) Study 2021, aiming to provide insights for forming effective global management and prevention strategies. Methods Stomach cancer incidence, prevalence, mortality, disability-adjusted life years (DALYs) and the corresponding age-standardized rates (ASRs) were estimated. Then, trends of the disease burden were analyzed using the estimated annual percentage changes (EAPC). Lastly, we made a unique attempt to use two powerful and versatile techniques, autoregressive integrated moving average (ARIMA) and exponential smoothing (ES) models, to provide more comprehensive and accurate forecasts for future trends in the disease burden. Results Despite the steady decreasing trend in age-standardized rates, the total numbers of incidence, prevalence, and deaths all increased from 1990 to 2021. Subgroup analysis demonstrated great disparities in different age and gender groups, sociodemographic index (SDI) quintiles, GBD regions and countries. Both the ARIMA and ES models demonstrated a persistent rise in SC cases and a concurrent decline in ASRs, with the trend being more pronounced in males. Conclusion Since SC is already a significant health issue globally, it is expected that the estimated disease burden will continue to rise in the future. Therefore, global coordinated efforts are needed to implement effective screening projects, consolidate preventive measures and formulate targeted treatments to alleviate the SC burden.

Trends, patterns, and risk factors of esophageal cancer mortality in China, 2008-2021: A National Mortality Surveillance System data analysis

INTRODUCTION

According to the International Agency for Research on Cancer, China had the highest mortality burden of esophageal cancer (EC) globally in 2022.

OBJECTIVES

This study aims to analyze the national and provincial trends, patterns, and risk factors of EC deaths in China.

METHODS

Data from the National Mortality Surveillance System were used to estimate national and provincial deaths, age-standardized mortality rates (ASMRs), and years of life lost (YLL). An age-period-cohort-based Nordpred model was used to predict trends until 2030. Multilevel Poisson and logistic regression were conductedto assess factors influencing EC mortality and the place of death.

RESULTS

From 2008 to 2021, EC deaths and YLLs decreased from 227,677 to 167,529 and from 5.32 million to 3.50 million, respectively. Meanwhile, the ASMR and age-standardized YLL rate decreased from 24.34 to 11.01 per 100,000 and from 535.91 to 231.08 per 100,000, respectively. By 2030, EC deaths and ASMR are predicted to decline to 150,768 and 7.85 per 100,000, respectively. Nationwide, the average age at death increased from 68.46 to 72.45 years, with an increasing proportion of YLLs in the 65-69 age group. Overall premature mortality was observed to decrease, except for an increase in YLLs among urban populations aged ≥60 years. Higher burdens were observed in rural areas compared to urban areas and among males compared to females. Nationwide, individuals with agriculture-related occupations and lower educational levels exhibited significantly higher risks of EC death. Regions with higher prevalences of smoking and harmful drinking, and lower educational, economic, and medical levels were significantly associated with high mortality. Home was the leading place of EC deaths (80.02 %).

CONCLUSION

The EC mortality burden in China is decreasing but remains a significant threat to public health. Promoting education, occupational prevention, healthy lifestyles, and medical treatment for targeted populations and regions is essential.

Global burden of mental disorders in 204 countries and territories, 1990-2021: results from the global burden of disease study 2021

BACKGROUND

Mental disorders, one of the leading causes of the global health-related burden, which has been exacerbated by the emergence of the COVID-19 pandemic (2019-2021). In this study, we aim to provide global, regional, and national estimates of the mental disorders burden from 1990 to 2021, including during the COVID-19.

METHODS

We collected data from the Global Burden of Disease Study 2021 (GBD 2021) on the incidence, disability-adjusted life years (DALYs), age-standardized incidence rate (ASIR), and age-standardized DALY rate (ASR) of 12 mental disorders from 204 countries and regions. The socio-demographic index (SDI) was used to evaluate the correlation between mental disorders burden and different regions. We utilized joinpoint regression analysis to estimate the average annual percentage change (AAPC).

RESULTS

In 2021, there were 444,397,716 incident cases and 155,418,119 DALYs globally from mental disorders. From 1990 to 2021, there was an upward trend in both ASIR [15.23% (12.97-17.60%)] and ASR [17.28% (15.06-19.44%)]. In 2021, the highest ASIR was observed in Central Sub-Saharan Africa (8706.11), while the lowest was in East Asia (3340.99). Australia (2787.87) had the highest ASR. Nationally, Greenland, Greece, the United States, and Australia had the highest ASRs. During the COVID-19 pandemic, aside from East Asia, both the ASIR showed an upward trend in the five SDI and other GBD regions. In 2021, the ASR for females was higher than that for males. Among the 12 subtypes, major depressive disorder (557.87) and anxiety disorders (524.33) had the highest ASR. Major depressive disorder ranked first in ASR in 13 of the 21 regions worldwide. Despite the overall upward trend in DALYs for mental disorders [AAPC: 5.96; 95%CI: (4.99, 6.92)], the ASR exhibited varying trends among different subtypes, with anxiety disorders experiencing the most significant increase.

CONCLUSIONS

GBD 2021 showed that the burden of mental disorders has increased over the past three decades, with notable regional disparities. High SDI regions and females should be paid more attention. To alleviate future burdens, providing comprehensive mental health support, establishing effective mental health knowledge dissemination and tailored interventions are in great need.

CLINICAL TRIAL NUMBER

Not applicable.

Exploring temporal trends and influencing factors for upper digestive tract cancers in Guangzhou, China: 2010-2020

BACKGROUND

The burden of upper digestive tract cancers is heavy in China and the world. This study was conducted to investigate the temporal trends and influencing factors associated with the incidence of upper digestive tract cancers in Guangzhou, China, from 2010 to 2020.

METHODS

In this study, a jointpoint regression model was employed to analyze the temporal trends in the incidence of upper digestive tract cancers. Additionally, grey correlation analysis was utilized to examine the impact of correlation factors on the observed trends.

RESULTS

Cancer incidence data came from Guangzhou Cancer Registry and population data came from Guangzhou Bureau of Statistics. Between 2010 and 2020, there were 5375 reported cases of esophageal cancer (EC) and 10,880 cases of gastric cancer (GC) in the region. The incidence rates were consistently higher in men than in women, with the highest rates observed in both genders among individuals aged 80-84. Joinpoint regression analysis indicated a general decreasing trend in the incidence of both EC and GC. The incidence of EC in females has decreased significantly faster than in males, while the incidence of GC in females has remained more stable. Additionally, economic, medical, soil, and air quality factors are closely related to the incidence of these two types of cancer, although there are some differences between them.

CONCLUSION

The disease burden of upper digestive tract cancers in Guangzhou is relatively low. This study offers a social perspective for understanding and managing upper digestive tract cancers, and it provides valuable insights for optimizing cancer control strategies in other high-risk regions.

Gallbladder and biliary tract cancer burdens in China from 1990 to 2021 and projection to 2044: findings from the 2021 Global Burden of Disease study

Background

Gallbladder and biliary tract cancers (GBTCs) have high incidence and mortality rates in China, imposing a substantial disease burden. Establishing comprehensive strategies is crucial for alleviating this burden. We report the average estimated annual percentage change (EAPC) in age-standardized rates (ASRs) of GBTCs globally and in China via Global Burden of Disease (GBD) study 2021 data and the relationships of GBTCs with body mass index (BMI) and the sociodemographic index (SDI). The 2021-2044 GBTCs prevalence trends were predicted by sex.

Methods

We collected and analyzed GBD data from 1990 to 2021, including incidence, prevalence, deaths, disability-adjusted life years (DALYs), and age-standardized incidence (ASIR), prevalence (ASPR), mortality (ASMR), and DALYs (ASDR) rates and calculated the proportion of deaths and DALYs attributable to risk factors by sex. Future trends from 2022 to 2044 were predicted with Nordpred age-period-cohort models.

Results

The number of GBTCs-related incident cases, prevalent cases, deaths, and DALYs increased from 1990 to 2021. However, the GBTCs-related ASMR and ASDR decreased during the same period. These changes may be related to risk factors, such as increased BMI. Furthermore, we used the projection model to estimate that the GBTCs-related ASPR in all populations will steadily increase, whereas the GBTCs-related ASMR and ASDR are expected to significantly decline until 2044.

Conclusion

The increasing GBTCs prevalence in China due to SDI advancements and population aging underscores the importance of early monitoring and prevention measures to alleviate the disease burden.

Esophageal squamous cell carcinoma with colonic and rectal metastases: a rare case report

As a common malignant tumor, esophageal cancer is easy to relapse and distant metastasis, and the prognosis is very poor. Colon and rectal metastasis of esophageal cancer is extremely rare. This study reports a case of colorectal and rectal metastasis in an esophageal squamous cell carcinoma patient. The patient was a 65-year-old man who presented with progressive swallowing obstruction. Gastroscopy and pathological biopsy revealed low-differentiated squamous cell carcinoma in the lower esophagus (32cm from the incisor). After completing the relevant examination, the patient was evaluated by the thoracic surgeon and showed no indication of surgery. Then the patient was received 2 cycles of Abraxane plus cisplatin with Sintilimab. After the treatment, the esophageal lesion was examined by Chest CT, and assesses again by the surgeon again and radical radiotherapy was recommended without indication of surgery. After radiotherapy, the patient underwent comprehensive imaging examination. Abdominal CT showed mass in the lower abdomen. Colonoscopy and pathological biopsy showed squamous cell carcinoma of colon and rectum. According to the pathological type and tumor monism, and communication with the pathologist, the patient was diagnosed to be esophageal cancer with rectal and colon metastasis. Through this case report, we hope to deepen the understanding of rare esophageal squamous cell metastasis, and comprehensive examination should be conducted before initial treatment to evaluate the tumor status.

The Burden of Esophageal Cancer in Five East Asian Countries From 1990 to 2021 and Its Prediction Until 2036: An Analysis of the Global Burden of Diseases Study 2021

BACKGROUND

In 2022, esophageal cancer (EC) was the eleventh most frequently diagnosed cancer and the seventh leading cause of cancer-related deaths worldwide. Nonetheless, the prevalence and burden of EC in Asian countries have been little studied. This study investigated the prevalence, incidence, and burden of EC in five East Asian countries from 1990 to 2021.

METHODS

We retrieved data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 on the prevalence, incidence, mortality, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs) associated with EC in five East Asian countries from 1990 to 2021. The epidemiological characteristics of EC were analyzed by joinpoint regression, age-period-cohort analysis, and decomposition analysis. The burden of EC until 2036 was estimated using autoregressive integrated moving average and Bayesian age-period-cohort models.

RESULTS

Among these East Asian countries, China had the highest incidence, prevalence, mortality rates, YLLs, YLDs, and DALYs in 1990 and 2021. China and Mongolia exhibited the highest age-standardized incidence rate, age-standardized mortality rate, age-standardized prevalence rate, age-standardized YLDs rate, age-standardized YLLs rate, and age-standardized DALYs rate from 1990 to 2036. The age group with the highest prevalence rate, incidence rate, mortality rate, YLDs rate, YLLs rate, and DALYs rate in these countries was ≥ 55 years. The prevalence and incidence rates in the five countries were influenced by aging and were higher than the global average.

CONCLUSIONS

The burden of EC in five East Asian countries was high over the past three decades, particularly among older adults. EC is a significant public health problem in these countries, particularly because of the large population base and aging demographics.

Impact of Collaborative Empowerment Education on Psychological Distress, Quality of Life, and Nutritional Status in Esophageal Cancer Patients Undergoing Concurrent Chemoradiotherapy

Esophageal cancer (EC) patients undergoing concurrent chemoradiotherapy (CCRT) often face significant psychological distress, impaired quality of life (QoL), and poor nutritional status. This study evaluates the impact of multidisciplinary collaborative empowerment education (MCEE) in addressing these challenges. According to the inclusion criteria, 160 patients were recruited and randomly assigned to either the MCEE group (n = 80) or the control group (n = 80). The MCEE group received a tailored program consisting of psychological support, nutritional counseling, and educational interventions. Outcome measures, including psychological distress (using the Kessler Psychological Distress Scale), quality of life (using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire), and nutritional status (using hemoglobin, serum protein, and albumin levels), were evaluated at baseline and after four cycles of concurrent chemoradiotherapy. Post-intervention, the MCEE group showed significant improvements in psychological distress. QoL improvements were noted across all functional domains, including physical, emotional, cognitive, and social functions (all Ps ≤ 0.001), with significant reductions in fatigue, insomnia, and pain. Nutritional status also improved, with higher levels of hemoglobin, serum protein, and albumin, as well as less weight loss in the intervention group (all Ps ≤ 0.001). MCEE effectively reduces psychological distress, improves QoL, and enhances nutritional status in EC patients undergoing CCRT. This patient-centered, multidisciplinary approach offers a promising strategy for improving treatment outcomes and overall well-being in cancer care.

Global, regional, and national burdens of ischemic heart disease in the older adults aged 60-89 years: a systematic analysis for the Global Burden of Disease Study 2019

Background

Ischemic heart disease (IHD) places a heavy burden on individual and public health. Nevertheless, comprehensive assessments of the burden of IHD in the elderly are absent. It is imperative to update the burden of IHD in older adults and predict the trends.

Methods

The absolute numbers and age-standardized rates (ASRs) of prevalence, mortality, and disability-adjusted life-years (DALYs) for IHD among people aged 60-89 years from 1990 to 2019 were analyzed based on the Global Burden of Disease Study 2019 (GBD 2019). Joinpoint regression analysis was utilized to evaluate the epidemiologic trend of IHD in the elderly from 1990 to 2019. Bayesian age-period-cohort model was used to predict the burden of IHD among the elderly from 2020 to 2034.

Results

Age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), age-standardized DALY rate (ASDR), and age-standardized mortality rate (ASMR) of IHD in older adults have declined slightly over the past 30 years. In 2019, the ASPR, ASIR, ASDR, and ASMR among the elderly with IHD were 14,280.53 (95% UI, 12,301.34-16,610.6), 1,445.21 (1,142-1,793.58), 11,225.74 (10,342.09-11,960.64), and 675.24 (614.21-721.75) per 100,000. The burden of IHD was significantly higher in older men than in women during the study period. In terms of socio-demographic index (SDI), countries and territories with lower SDI bore a more severe burden of IHD. The burden of IHD in the elderly varied considerably across countries. Uzbekistan had the largest increase in rates of prevalence, incidence, DALY, and mortality. The projections show a downward trend in DALY and mortality rates for IHD in older adults from 2020 to 2034, but incidence and prevalence will increase.

Conclusion

From 1990 to 2019, the worldwide burden of IHD among the elderly witnessed a decline. The IHD burden varied significantly across countries and territories. Policymakers should rationalize the allocation of health resources and implement effective prevention and treatment strategies to reduce the burden of IHD among the elderly in economically less developed countries and regions.

Spatiotemporal Correlation Analysis for the Incidence of Esophageal and Gastric Cancer From 2010 to 2019: Ecological Study

Background

Esophageal and gastric cancer were among the top 10 most common cancers worldwide. In addition, sex-specific differences were observed in the incidence. Due to their anatomic proximity, the 2 cancers have both different but also shared risk factors and epidemiological features. Exploring the potential correlated incidence pattern of them, holds significant importance in providing clues in the etiology and preventive strategies.

Objective

This study aims to explore the spatiotemporal correlation between the incidence patterns of esophageal and gastric cancer in 204 countries and territories from 2010 to 2019 so that prevention and control strategies can be more effective.

Methods

The data of esophageal and gastric cancer were sourced from the Global Burden of Disease (GBD). Spatial autocorrelation analysis using Moran I in ArcGIS 10.8 (Esri) was performed to determine spatial clustering of each cancer incidence. We classified different risk areas based on the risk ratio (RR) of the 2 cancers in various countries to the global, and the correlation between their RR was evaluated using Pearson correlation coefficient. Temporal trends were quantified by calculating the average annual percent change (AAPC), and the correlation between the temporal trends of both cancers was evaluated using Pearson correlation coefficients.

Results

In 2019, among 204 countries and territories, the age-standardized incidence rates (ASIR) of esophageal cancer ranged from 0.91 (95% CI 0.65-1.58) to 24.53 (95% CI 18.74-32.51), and the ASIR of gastric cancer ranged from 3.28 (95% CI 2.67-3.91) to 43.70 (95% CI 34.29-55.10). Malawi was identified as the highest risk for esophageal cancer (male RR=3.27; female RR=5.19) and low risk for gastric cancer (male RR=0.21; female RR=0.23) in both sexes. Spatial autocorrelation analysis revealed significant spatial clustering of the incidence for both cancers (Moran I>0.20 and P<.001). A positive correlation between the risk of esophageal and gastric cancer was observed in males (r=0.25, P<.001). The ASIR of both cancers showed a decreasing trend globally. The ASIR for esophageal and gastric cancer showed an AAPC of -1.43 (95% CI -1.58 to -1.27) and -1.76 (95% CI -2.08 to -1.43) in males, and -1.93 (95% CI -2.11 to -1.75) and -1.79 (95% CI -2.13 to -1.46) in females. In addition, a positive correlation between the temporal trends in ASIR for both cancers was observed at the global level across sexes (male r=0.98; female r=0.98).

Conclusions

Our study shows that there was a significant spatial clustering of the incidence for esophageal and gastric cancer and a positive correlation between the risk of both cancers across countries was observed in males. In addition, a codescending incidence trend between both cancers was observed at the global level.

Global, regional, and national esophageal cancer deaths and DALYs attributable to diet low in vegetables and fruits, 1990-2019: analysis for the global burden of disease study

Background

This study aimed to comprehensively assess the global, regional, and national burden of esophageal cancer (EC) attributable to inadequate vegetable and fruit intake from 1990 to 2019 and explore the potential impact of existing dietary intervention programs on EC prevention.

Methods

Using the Global Burden of Disease Study 2019 (GBD 2019) database, we conducted descriptive analyses stratified by age, sex, Socio-demographic Index (SDI), and regional levels. Temporal trends were assessed using linear regression models, and cluster analysis was employed to explore burden patterns across different GBD regions. Decomposition analysis quantified the contributions of aging, population dynamics, and epidemiological changes to deaths and disability-adjusted life years (DALYs). Frontier analysis was used to evaluate the relationship between dietary risk-related disease burden and sociodemographic progress.

Results

In 2019, inadequate vegetable and fruit intake contributed to 65,919 global EC deaths, accounting for 0.12% of all deaths, with an age-standardized death rate of 0.81 per 100,000 population. The associated DALYs totaled 16,065,68, representing 0.06% of total global DALYs, with an age-standardized DALY rate of 19.24. The disease burden attributable to insufficient fruit intake (51,210 deaths, 12,497,75 DALYs) was significantly higher than that from inadequate vegetable intake (17,176 deaths, 4,203,09 DALYs). The burden was greater in males than females, peaking in middle-aged groups. Substantial regional differences were observed, with low-SDI regions bearing the highest burden. From 1990 to 2019, while the absolute numbers of deaths and DALYs followed a complex trajectory of initial increase followed by decline, age-standardized rates consistently decreased, reflecting the positive impact of epidemiological improvements. Existing dietary intervention programs, such as subsidies for fruit and vegetable production and health education initiatives, have contributed to a reduction in dietary risk-related disease burden but exhibited varying effectiveness across SDI regions.

Conclusion

Targeted dietary interventions, such as promoting fruit and vegetable consumption, are critical for the prevention and control of the EC disease burden. Future efforts should focus on optimizing the implementation of current programs, enhancing nutritional supplementation in resource-limited regions, and expanding health education initiatives to achieve broader health benefits.

The burden of Gastric Cancer and possible risk factors from 1990 to 2021, and projections until 2035: findings from the Global Burden of Disease Study 2021

BACKGROUND AND OBJECTIVE

Gastric cancer (GC) remains a significant global health challenge, characterized by high incidence and mortality rates, particularly in East Asia. A comprehensive understanding of the disease burden of gastric cancer is crucial for developing effective prevention and treatment strategies. However, comprehensive global assessments of the disease burden of gastric cancer remain limited. This study, based on the Global Burden of Disease (GBD) framework, systematically analyzes global trends in gastric cancer from 1990 to 2021 and projects future trends through 2035, aiming to provide scientific evidence for policymaking.

METHODS

The data were derived from the Global Burden of Disease (GBD) Study 2021, covering gastric cancer (GC) incidence, mortality, disability-adjusted life years (DALYs), age-standardized incidence rates (ASIRs), age-standardized death rates (ASDRs), and age-standardized DALY rates (ASRs) across 204 countries and regions from 1990 to 2021. The Bayesian age-period-cohort model was employed to project trends up to 2035.

RESULTS

In comparison with 1990, both the incidence and mortality of GC rose in 2021, with over 1.23 million new cases recorded globally, resulting in 954,373.60 deaths and 22,786,633.10 DALYs. Between 1990 and 2021, the ASIRs, ASDRs, and ASRs decreased by 42% (ranging from 49 to 35%), 49% (ranging from 55 to 43%), and 53% (ranging from 58 to 47%), respectively. The peak ASIRs and ASDRs in 2021 were seen in the high-middle SDI quintile. Males exhibited higher rates of ASDRs, ASIRs, and ASRs compared to females. In 2021, East Asia and high-income North America bore the largest burden of smoking-related GC, while Central Europe experienced the highest burden from high-sodium diets. Forecasts toward 2035 indicate a continued decline in both ASIRs and ASDRs.

CONCLUSIONS

Despite notable reductions in both incidence and mortality, GC remains a substantial global burden, affecting various regions and countries. Deaths and DALYs related to high-sodium diets and smoking have shown an overall decline. However, substantial regional and age-related disparities persist. Targeted interventions, such as smoking control and promoting the intake of fresh fruits and vegetables, are essential in diminishing GC risk.

Disparities, Trends, and Predictions to 2040 in Gastrointestinal Cancer Incidence, Mortality in the United States

INTRODUCTION

Growing gastrointestinal cancers in the United States necessitate further research due to substantial health care and economic impacts. The aim of this study was to analyze trends and future projections for 5 major gastrointestinal cancers (colorectal, pancreatic, liver, stomach, and esophageal).

METHODS

Data were sourced from the Surveillance, Epidemiology, and End Results database; National Center for Health Statistics; and Global Burden of Diseases databases. An age-period-cohort model using the Bayesian Information Criterion method was applied to project incidence and mortality rates to 2040.

RESULTS

Men consistently exhibited higher incidence and mortality rates across all gastrointestinal cancers, with significant variation across the 51 US states. From 2000 to 2020, colorectal cancer incidence and mortality rates declined across all racial groups, except for the incidence rates of American Indian and Alaska Native (AIAN) men, Hispanic men, and Hispanic women, which remained stable. Pancreatic cancer incidence increased across all groups except for AIAN men, while mortality rates rose only for White men and Hispanic women. Liver cancer incidence rose among AIAN men and White, AIAN, and Hispanic women, while mortality rates declined for most groups. Stomach cancer incidence and mortality either declined or stabilized, and esophageal cancer rates showed a general decline. By 2040, increases in incidence and mortality are projected for most gastrointestinal cancers, particularly in men.

DISCUSSION

Despite varied trends over the past 2 decades, an overall increase in gastrointestinal cancer incidence and mortality rates is anticipated in the next 20 years in the United States, underscoring the need for effective prevention and intervention strategies.

Global, Regional and National Burden of Paediatric Atopic Dermatitis: A Trend and Geographic Inequalities Analysis

BACKGROUND

Atopic dermatitis (AD) is a common chronic skin disorder in children. We aimed to investigate trends and regional disparities of burden in paediatric AD at global, regional and national levels, and to explore potential associated factors.

METHODS

Based on data from Global Burden of Disease study 2019, we assessed trends in burden of AD aged <19 years from 1990 to 2019, including prevalent and incident cases, age-standardised prevalence and age-standardised incidence. For potential associated factors, correlations of above trends and indexes of socio-economic status (sociodemographic index, SDI) and health service coverage (universal health coverage index, UHCI) were evaluated. We conducted decomposition analysis to understand the net contribution of population-level factors and their contribution proportions on changes of prevalent and incident cases, including age structure, population change and epidemiological change.

RESULTS

Global prevalent and incident cases of paediatric AD increased by about 5.7 and 0.7 million between 1990 and 2019, respectively. Global age-standardised prevalence and incidence decreased by -0.17% (-0.19% to -0.16%) and -0.12% (-0.13% to -0.11%) per year from 1990 to 2019, respectively. Regionally, the highest increase of prevalent and incident cases was in low SDI region (by 96.77% and 84.85%); the highest decrease of age-standardised prevalence and incidence was in high SDI regions (by -0.20% and -0.27% per year). The correlation analyses identified significant negative correlations between trends and SDI and UHCI. Population change was a major driver of case rise; epidemiological change and age structure showed negative impact of case rise. Regional disparities in contribution of three population-level factors were seen, including net contribution direction (positive or negative) and contribution proportion levels.

CONCLUSION

Global paediatric AD case numbers increased, primarily due to population growth. Prevalence and incidence decreased slightly. Geographic inequalities were seen. Developing region-specific strategies targeting potential factors is essential to reduce paediatric AD burden.

The spatiotemporal associations between esophageal and gastric cancers provide evidence for its joint endoscopic screening in China: a population-based study

BACKGROUND

The spatiotemporal epidemiological evidence supporting joint endoscopic screening for esophageal cancer (EC) and gastric cancer (GC) remains limited. This study aims to identify combined high-risk regions for EC and GC and determine optimal areas for joint and separate endoscopic screening.

METHODS

We analyzed the association of incidence trends between EC and GC in cancer registry areas across China from 2006 to 2016 using spatiotemporal statistical methods. Based on these analyses, we divided different combined risk regions for EC and GC to implement joint endoscopic screening.

RESULTS

From 2006 to 2016, national incidence trends for both EC and GC showed a decline, with an average annual percentage change of -3.15 (95% confidence interval [CI]: -5.33 to -0.92) for EC and -3.78 (95% CI: -4.98 to -2.56) for GC. A grey comprehensive correlation analysis revealed a strong temporal association between the incidence trends of EC and GC, with correlations of 79.00% (95% CI: 77.85 to 80.14) in males and 77.62% (95% CI: 76.50 to 78.73) in females. Geographic patterns of EC and GC varied, demonstrating both homogeneity and heterogeneity across different regions. The cancer registry areas were classified into seven distinct combined risk regions, with 33 areas identified as high-risk for both EC and GC, highlighting these regions as priorities for joint endoscopic screening.

CONCLUSION

This study demonstrates a significant spatiotemporal association between EC and GC. The identified combined risk regions provide a valuable basis for optimizing joint endoscopic screening strategies for these cancers.

Global, regional and national epidemiology of allergic disorders in children from 1990 to 2019: findings from the Global Burden of Disease study 2019

OBJECTIVE

This modelling study aimed to estimate the burden for allergic diseases in children during a period of 30 years.

DESIGN

Population-based observational study.

MAIN OUTCOMES AND MEASURES

The data on the incidence, mortality and disability-adjusted life years (DALYs) for childhood allergic diseases, such as atopic dermatitis (AD) and asthma, were retrieved from the Global Burden of Disease study 2019 online database. This data set spans various groups, including different regions, ages, genders and Socio-Demographic Indices (SDI), covering the period from 1990 to 2019.

RESULTS

In 2019, there were approximately 81 million children with asthma and 5.6 million children with AD worldwide. The global incidence of asthma in children was 20 million. Age-standardised incidence rates showed a decrease of 4.17% for asthma, from 1075.14 (95% uncertainty intervals (UI), 724.63 to 1504.93) per 100 000 population in 1990 to 1030.33 (95% UI, 683.66 to 1449.53) in 2019. Similarly, the rates for AD decreased by 5.46%, from 594.05 (95% UI, 547.98 to 642.88) per 100 000 population in 1990 to 561.61 (95% UI, 519.03 to 608.29) in 2019. The incidence of both asthma and AD was highest in children under 5 years of age, gradually decreasing with age. Interestingly, an increase in SDI was associated with a rise in the incidence of both conditions. However, the mortality rate and DALYs for asthma showed a contrasting trend.

CONCLUSIONS

Over the past three decades, there has been a worldwide increase in new asthma and AD cases, even though mortality rates have significantly declined. However, the prevalence of these allergic diseases among children varies considerably across regions, countries and age groups. This variation highlights the need for precise prevalence assessments. These assessments are vital in formulating effective strategies for prevention and treatment.

Gastric cancer in Spain: evaluating productivity loss and economic impact

INTRODUCTION

In 2018, gastric cancer (GC) was estimated to account for over 1.03 million new cases globally, making it one of the most frequently diagnosed malignancies. In Spain, about 6,913 new cases were diagnosed in 2022. GC is an aggressive cancer originating in the stomach and ranks fifth in cancer incidence and third in cancer-related deaths worldwide. Despite treatment, only 25% of patients survive more than 5 years after diagnosis.

METHODS

To estimate the economic impact of premature mortality due to GC, the human capital method was employed. This approach involved collecting data on mortality rates, average salaries, and unemployment rates. The study spanned a 10-year period, from 2013 to 2022, to integrate the latest and most pertinent data for analysis. The goal was to quantify the economic consequences GC-related deaths, providing valuable information for policy makers and healthcare professionals.

RESULTS

GC caused 51,814 deaths over the study period with a slight annual decline, predominantly affecting men. Approximately 23% of deaths occurred among people of working age, amounting to a total of 122,632 YPLL. In economic terms, GC deaths accounted for costs of €1,239.34 million in 2013, rising to €1,242.04 million by 2021, for a total of €11,469.07 million over the study period.

CONCLUSIONS

The incidence of gastrointestinal cancers has decline in some types, but they remain a substantial public health challenge. These findings underline the significant health and economic challenges posed by GC, highlighting the need for targeted interventions to mitigate its impact on both individuals and healthcare systems.