Trends in early- and late-onset gastrointestinal cancer mortality in Spain, 1999-2023

this study analyses mortality trends in early-onset gastrointestinal cancers (EOGIC, < 50 years) in Spain between 1999 and 2023, comparing them with those of late-onset cancers (≥ 50 years).

data from the Spanish National Institute of Statistics were used to calculate age-standardized mortality rates. Joinpoint regression was applied to identify trend changes, reporting average annual percentage change (AAPC) and annual percentage change (APC), with 95 % confidence intervals.

EOGIC mortality declined across most cancer sites and in both sexes. Among men, the largest decreases were observed in esophageal (-5.6 %) and stomach cancers (-4.0 %), followed by liver (-3.7 %) and colon (-3.2 %). In women, esophageal cancer showed the greatest reduction (-4.3 %), followed by colon (-2.6 %), stomach (-2.2 %), rectal and liver cancers. Pancreatic cancer mortality remained stable in younger women but began to decline from 2007 onwards (-1.2 %). In adults aged 50 and over, trends were more variable: pancreatic cancer mortality increased (men: +1.0 %; women: +1.6 %), while stomach cancer mortality declined (men: -3.3 %; women: -2.9 %). Colon cancer showed steeper declines from 2011-2012. Liver, rectal and other digestive cancers showed modest decreases. Esophageal cancer mortality declined in men but remained stable in women.

EOGIC mortality in Spain declined steadily over the study period, whereas trends in late-onset cancers were more irregular. These findings highlight the need for age-specific cancer prevention and control strategies.