Southeast Asia burden and trend of Gastrointestinal tract cancers from 1990 to 2021 and its prediction to 2050: findings from the Global Burden of Disease Study 2021.

Background: The burden of disease associated with gastrointestinal (GI) tract cancer in Southeast Asia has changed significantly in recent years. This study analyzes data from the Global Burden of Disease Study (GBD)-2021 to examine trends in the burden of GI tract cancers in Southeast Asia from 1990 to 2021, identifies key risk factors, and predicts future trends.

Method: First, this study obtained data on GI tract cancer by age, sex, etiology, incidence, prevalence, deaths, disability-adjusted life years (DALYs), and risk factor from the GBD-2021 study focused on Southeast Asia data from 1990 to 2021. Secondly, the study also examined the temporal trend of subtype-specific GI tract cancer disease burden in Southeast Asia from 1990 to 2021 using linear regression modeling to calculate estimated annual percentage change (EAPC) values. The autoregressive integrated moving average (ARIMA) model was also used to project the future disease burden from 2022 to 2050. Finally, risk factors for GI tract cancer of different etiologies were also analyzed.

Results: In 2021, the number of deaths, DALYs, incidence, and prevalence cases of GI tract cancers in Southeast Asia were about 216,074, 5,955,050, 258,629, and 686,835, respectively, with colorectal cancer (CRC) associated with the most severe burden of disease. Between 1990 and 2021, the number of deaths and DALYs associated with CRC and pancreatic cancer (PC) and the corresponding age-standardized rates (ASRs) showed a significant upward trend, with the fastest growth being in PC. The total number of esophageal (EC), gastric (GC), liver (LC), and gallbladder and biliary tract (GBTC) cancer-related deaths and DALYs increased, but the age-standardized rates declined significantly. Predictive data suggest that age-standardized death rate (ASDR), ASR of DALYs, age-standardized incidence rate (ASIR), and age-standardized prevalence rate (ASPR) will continue to decline in EC, GC, and LC, with the most pronounced declines, especially in GC. Overall, ASRs will continue to rise in the cases of CRC, PC, and GBTC cancers. ASDRs associated with GI tract cancers are greatest among those over 90 years of age. The burden of disease is significantly greater in men than in women, and this gender-induced difference is most pronounced in LC.

Conclusion: While the disease burden of various types of gastrointestinal (GI) cancers in Southeast Asia is experiencing both increases and declines, the overall burden remains significant, with the total number of cases expected to rise in the coming years. To alleviate the impact of severe GI cancers, public health professionals and policymakers must proactively develop and adapt prevention and control strategies, ensuring they are aligned with the shifting disease trends and the evolving risk factors associated with each type of GI tumor.