Background & Aims

There were an estimated 4.8 million new cases of gastrointestinal (GI) cancers and 3.4 million related deaths, worldwide, in 2018. GI cancers account for 26% of the global cancer incidence and 35% of all cancer-related deaths. We investigated the global burden from the 5 major GI cancers, as well as geographic and temporal trends in cancer-specific incidence and mortality.

Methods

Data on primary cancers of the esophagus, stomach, colorectum, liver, and pancreas were extracted from the GLOBOCAN database for the year 2018, as well as from the Cancer Incidence in 5 Continents series, and the World Health Organization mortality database from 1960 onward. Age-standardized incidence and mortality rates were calculated by sex, country, and level of human development.

Results

We observed geographic and temporal variations in incidence and mortality for all 5 types of GI cancers. Esophageal, gastric, and liver cancers were more common in Asia than in other parts of the world, and the burden from colorectal and pancreatic cancers was highest in Europe and North America. There was a uniform decrease in gastric cancer incidence, but an increasing incidence of colorectal cancer in formerly low-incidence regions during the studied time period. We found slight increases in incidence of liver and pancreatic cancer in some high-income regions.

Conclusions

Although the incidence of some GI cancer types has decreased, this group of malignancies continues to pose major challenges to public health. Primary and secondary prevention measures are important for controlling these malignancies—most importantly reducing consumption of tobacco and alcohol, obesity control, immunizing populations against hepatitis B virus infection, and screening for colorectal cancer.

中文翻译：

---

5 种主要胃肠道癌症的全球负担。

背景与目标

2018 年，全球估计有 480 万新发胃肠道 (GI) 癌症病例和 340 万相关死亡病例。胃肠道癌症占全球癌症发病率的 26%，占所有癌症相关死亡的 35%。我们调查了 5 种主要胃肠道癌症的全球负担，以及癌症特定发病率和死亡率的地理和时间趋势。

方法

食管癌、胃癌、结直肠癌、肝癌和胰腺癌的原发性癌症数据来自 2018 年 GLOBOCAN 数据库、五大洲癌症发病率系列以及 1960 年以来世界卫生组织死亡率数据库。按性别、国家和人类发展水平计算年龄标准化发病率和死亡率。

结果

我们观察了所有 5 种胃肠道癌症的发病率和死亡率的地理和时间差异。食管癌、胃癌和肝癌在亚洲比世界其他地区更常见，结直肠癌和胰腺癌的负担在欧洲和北美最高。在研究期间，以前的低发病率地区胃癌发病率均匀下降，但结直肠癌发病率上升。我们发现一些高收入地区肝癌和胰腺癌的发病率略有上升。

结论

尽管某些胃肠道癌症的发病率有所下降，但这类恶性肿瘤继续对公共卫生构成重大挑战。一级和二级预防措施对于控制这些恶性肿瘤非常重要，最重要的是减少烟草和酒精的消费、控制肥胖、对人群进行乙型肝炎病毒感染的免疫接种以及筛查结直肠癌。