Shifting global patterns of early-onset gastrointestinal cancers: lessons from the Spanish trends

This letter meaningfully expands the recent Cayuela et al study published in this journal by situating Spain's observed early-onset gastrointestinal cancer trends within a robust global framework, using GLOBOCAN projections to distinguish declining age-standardised risk from shifting absolute burden driven by demographic change. By integrating HDI-stratified forecasts for early-onset stomach and oesophageal cancers, it reinforces the authors' interpretation of early-onset malignancies as sentinel indicators while avoiding overextension of national findings. Together, the study and this correspondence provide a more complete, policy-relevant narrative that links successful national prevention to emerging global inequities and future cancer control priorities.