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Area of Science:

  • Oncology
  • Epidemiology
  • Public Health

Background:

  • Gastrointestinal cancers (GICs) present a significant public health challenge, with shifting trends from infection-related to metabolic risk factors.
  • Analyzing long-term incidence trends of early- and late-onset GICs in Spain provides crucial insights into evolving cancer epidemiology.

Purpose of the Study:

  • To analyze long-term incidence trends of early- and late-onset gastrointestinal cancers (GICs) in Spain from 1999 to 2023.
  • To identify shifts in GIC subtypes and age groups, distinguishing between infection-related and metabolic risk factors.

Main Methods:

  • Retrospective ecological time-trend analysis using Global Burden of Disease (GBD) 2023 incidence data.
  • Calculation of age-standardized incidence rates (ASIRs) for specific GICs by sex and age group (<50, ≥50 years).
  • Joinpoint regression analysis to assess temporal trends (APC, AAPC).

Main Results:

  • In adults ≥50 years, gastric and esophageal cancers declined, while pancreatic and liver cancers increased; colorectal cancer stabilized in women and rose slightly in men.
  • In individuals <50 years, overall GIC incidence decreased, with notable declines in esophageal and colorectal cancers, though a plateau emerged post-2016.
  • Pancreatic and liver cancers showed early signs of stabilization or mild increase in young women.

Conclusions:

  • Spain has reduced infection- and tobacco-related GICs, demonstrating success of prevention strategies.
  • Rising incidence of metabolic-related malignancies (pancreatic, liver) and plateauing early-onset colorectal cancer trends require enhanced metabolic health policies.
  • Optimization of national screening programs is crucial to address evolving GIC trends.