Updated Epidemiology of Gastrointestinal Cancers in the Asia-Pacific: Evidence From GBD 2021 and GLOBOCAN 2022.

DNA Hypermethylation Contributes to Incomplete Synthesis of Carbohydrate Determinants in Gastrointestinal Cancer

BackgroundThe most recent results of Global Cancer Statistics indicated that gastrointestinal cancers, including gastric, colorectal, esophageal, and liver cancers, are among the most commonly diagnosed cancers worldwide. Previous reports from cancer registries in East Azerbaijan have shown that there is a high incidence of gastrointestinal cancer in this region, so we performed a trend analysis to determine the pattern of change over the last decade.MethodsIn total, 12 years of cancer registry data were collected from different sources in East Azerbaijan, and a data quality check was performed to ensure clean data. Using the 2000 World Health Organization standard population, we then generated age-standardized incidence rates (ASRs) for different cancers, and for each year from 1383 to 1394 of the Persian calendar (i.e., 19 March 2004 to 20 March 2015). Annual percent changes (APCs) and Average annual percent changes (AAPCs) in the ASRs for esophageal, gastric, small intestine, colorectal, anal, liver, gallbladder, and pancreatic cancers were calculated using Joinpoint Software (Version 4.5.0.1, June 2017).ResultsAn increase in most types of cancer was observed during the study period. The ASR for colorectal cancer increased from 2.9 to 13.6 per 100,000 women (APC, 9.7%) and from 2.2 to 17.8 per 100,000 men (APC, 10.2%). The ASR for gastric cancer showed a slight increasing trend from 10.5 to 13.5 per 100,000 women (APC, 1.3%) and from 3.1 to 29.9 per 100,000 men (APC, 3.2%). However, trend analysis showed a decreasing pattern for the ASR of esophageal cancer in both genders (APC,− 3%), with APCs of − 1.1% in females and − 0.4% in males.ConclusionsThe latest results of the East Azerbaijan Population-Based Cancer Registry indicate that gastrointestinal cancers remain common, with significant increasing trends in their ASRs. Improved screening and early detection are needed in this region.

Screening for GI cancer and payment mechanisms

BackgroundEarly-Onset Gastrointestinal Cancers concerns tumors in people under 50. Accumulating evidence suggests a significant increase in the burden of colorectal cancer in young adults. We investigated the global burden and spatiotemporal trends of the 6 major gastrointestinal (GI) cancers, including colon and rectum cancer (CRC), esophageal cancer (EC), gallbladder and biliary tract cancer (GBTC), liver cancer (LC), pancreatic cancer (PC), and stomach cancer (SC). in young adults, based on cancer-specific incidence and mortality.MethodsAll data for 6 early-onset (EO) GI cancers were obtained from the Global Burden of Disease study. Age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and corresponding estimated annual percentage change (EAPC) were calculated to assess temporal trends from 1990 to 2019.ResultsThe global number of cases and deaths from all EO-GI cancers has risen since 1990, reaching 539,750 and 309,200, respectively in 2019. ASIR and ASDR decreased for most EO-GI cancers (total, esophageal, gallbladder and biliary tract (GBTC), liver, and stomach cancers), while EO-pancreatic cancer showed an upward trend. EO colorectal cancer had increased incidence and stable mortality. However, these trends varied by sex, age, region, and economic status. Men had a higher burden of EO GI cancers (except GBTC), and older populations were more affected. Asia, particularly East Asia, had a significant burden, while the Americas showed the largest increase. Areas with Middle and High-middle sociodemographic indices had a relatively high burden of EO-GI cancers.ConclusionsThe absolute burden of EO-GI cancers is rising worldwide, but the standardized burden has decreased, This indicates that we have made considerable progress in treatment and early detection.

We aimed to explore the global burden and trends of early-onset gastrointestinal (GI) cancers, defined as those diagnosed in individuals younger than 50 years of age, from 1990 to 2021 based on the Global Burden of Disease Study 2021 (GBD 2021). Data of disability-adjusted life-years (DALYs), incidence, and corresponding age-standardized rates were extracted to assess the burden and trends of early-onset GI cancers, including esophageal, gastric, liver, colorectal, pancreatic, and gallbladder and biliary tract cancers from 1990 to 2021. Colorectal cancer had the highest age-standardized DALYs rate (ASDR) and incidence rate (ASIR) globally at 101.37 and 5.37 per 100 000 in 2021. Moreover, it showed the greatest ASIR growth over the past three decades, with projections indicating it would remain the leading cause by 2040. Colorectal, gastric, and liver cancers ranked the top three contributors to disease burden in 2021, with gastric cancer showing the most significant decline (average annual percentage change [AAPC] for ASDR: -2.27; for ASIR: -1.71). Elevatedbody mass index was the risk factor for most of these cancers, with AAPC ranging from 0.68 to 5.09. Additionally, early-onset pancreatic cancer had the greatest impact in Eastern Europe, while gallbladder and biliary tract cancer was more prevalent in Southern Latin America. East Asia had the heaviest burden of other cancers. Early-onset colorectal, gastric, and liver cancers were the top three contributors to disease burden in 2021. Preventing these cancers and reducing obesity should be the main priorities for public health.

Burden of gastrointestinal cancers in China from 1990 to 2019 and projection through 2029

According to 2009 estimates from the American Cancer Society, cancers originating in the gastrointestinal tract rank second in both incidence and cancer-related deaths. One in four deaths in the United States is caused by cancer, with 25% of cancer-related deaths caused by gastrointestinal (GI) malignancies; more than 50% of these deaths are caused by cancer of the pancreas, stomach, esophagus, liver, or biliary tract. Recent advances in molecular biology, medical genetics, and imaging and endoscopic techniques, as well as the development of antitumor agents, have significantly altered the approaches to the prevention, diagnosis, and treatment of GI cancers. The chapter covers esophageal, gastric, pancreatic, hepatocellular, biliary tract, and anal cancers, as well as GI stromal tumors and gastric lymphoma. Coverage of all cancers includes diagnosis and treatment; various sections include information on epidemiology, etiology, risk factors, screening and prevention, molecular mutations, pathogenesis, and/or metastatic disease. Figures depict a barium esophagogram showing squamous cell carcinoma; imaging of esophageal cancer, gastric cancer, and pancreatic cancer; a pedigree of a family with inactivation of germline mutation of E-cadherin; hereditary gastric cancer; gastric cancer survival rates after gastrectomy; axial T1-weighted magnetic resonance imaging (MRI) showing cancer of the pancreatic head; and T1- and T2-weighted MRIs of intrahepatic bile duct carcinoma. Tables provide information on new cases and mortality from GI cancer in 2009; guidelines for diagnosis and surveillance of Barrett esophagus; the declining incidence of gastric cancer in Japan, Slovenia, and the United States; TNM staging of gastric cancer, pancreatic cancer, and hepatocellular carcinoma; the incidence of familial pancreatic carcinoma; molecular mutations involved in pancreatic cancer; staging of pancreatic intraepithelial neoplasia; and the Chinese University Prognostic Index. This review contains 9 figures, 39 tables, and 173 references. Keywords: biliary cancer, carcinoma, endoscopic, esophageal, gastric, hepatic, lesions, lymphoma, malignant, mutations

According to 2009 estimates from the American Cancer Society, cancers originating in the gastrointestinal tract rank second in both incidence and cancer-related deaths. One in four deaths in the United States is caused by cancer, with 25% of cancer-related deaths caused by gastrointestinal (GI) malignancies; more than 50% of these deaths are caused by cancer of the pancreas, stomach, esophagus, liver, or biliary tract. Recent advances in molecular biology, medical genetics, and imaging and endoscopic techniques, as well as the development of antitumor agents, have significantly altered the approaches to the prevention, diagnosis, and treatment of GI cancers. The chapter covers esophageal, gastric, pancreatic, hepatocellular, biliary tract, and anal cancers, as well as GI stromal tumors and gastric lymphoma. Coverage of all cancers includes diagnosis and treatment; various sections include information on epidemiology, etiology, risk factors, screening and prevention, molecular mutations, pathogenesis, and/or metastatic disease. Figures depict a barium esophagogram showing squamous cell carcinoma; imaging of esophageal cancer, gastric cancer, and pancreatic cancer; a pedigree of a family with inactivation of germline mutation of E-cadherin; hereditary gastric cancer; gastric cancer survival rates after gastrectomy; axial T1-weighted magnetic resonance imaging (MRI) showing cancer of the pancreatic head; and T1- and T2-weighted MRIs of intrahepatic bile duct carcinoma. Tables provide information on new cases and mortality from GI cancer in 2009; guidelines for diagnosis and surveillance of Barrett esophagus; the declining incidence of gastric cancer in Japan, Slovenia, and the United States; TNM staging of gastric cancer, pancreatic cancer, and hepatocellular carcinoma; the incidence of familial pancreatic carcinoma; molecular mutations involved in pancreatic cancer; staging of pancreatic intraepithelial neoplasia; and the Chinese University Prognostic Index. This review contains 9 figures, 39 tables, and 173 references. Keywords: biliary cancer, carcinoma, endoscopic, esophageal, gastric, hepatic, lesions, lymphoma, malignant, mutations

Introduction: The incidence of early-onset gastrointestinal cancers (EO-GICs, diagnosed <50 years) is rising globally. Low- and middle-income countries such as Nepal face distinct exposures that might influence the disease patterns in younger populations. However, systematic evidence on EO-GICs in these settings is limited. This scoping review aimed to map the available evidence on EO-GICs from Nepal and identify gaps to guide future research and early detection strategies. Methods: This scoping review adhered to the PRISMA-ScR guidelines. Eligible studies included observational studies reporting on patients younger than 50 years with gastrointestinal malignancies (esophageal, gastric, colorectal, hepatobiliary, pancreatic, or gallbladder cancers) in Nepal, while secondary data articles and case reports were excluded. Databases searched included PubMed, NepJol, and relevant grey literature. Reference lists of included articles were also screened. After duplicate removal, titles and abstracts were independently screened by two reviewers, followed by full-text review. Data were synthesized descriptively in narrative formats. Results: A total of 17 hospital-based studies from Nepal were included among 39 records. The colorectal cancer burden was increasing among young adults, with approximately 28% of cases in patients ≤40 years (mean age 31.8-34.1 years). Gastric cancer predominantly affected older adults (mean age 57-63 years), yet 10-22% were under 50. Early-onset gastric cancer cases showed a female predominance and often presented at an advanced stage. Esophageal cancer was most frequent in patients aged 61-70 years (34%); however, 20% were diagnosed before 50 years. Hepatocellular carcinoma affected mainly middle-aged to older adults (mean ages 54-67 years), with 8-26% of cases in younger individuals. Linked risk factors included male sex, viral hepatitis, alcohol use, and cirrhosis; late-stage diagnosis was common. Gallbladder and biliary tract cancers presented in middle-aged adults (mean age 53-56 years), typically presenting at advanced stages, with associated risk factors including gallstones, high parity, early menarche, Terai/Madhesi and Janajati ethnicity, alcohol and pesticide exposure, and low fruit/vegetable intake. Conclusions: Early-onset gastrointestinal cancers in Nepal constitute a significant proportion of the cancer burden, particularly for colorectal and gastric cancers, with younger patients often presenting with distinct clinical features. However, the scarcity of population-based data, national screening programs, and large cohort studies highlights critical knowledge gaps that must be addressed to inform early detection strategies, risk stratification, and targeted interventions in this population. Citation Format: Saroj GC, Bishal Paudel. Epidemiology of early-onset gastrointestinal cancers in Nepal: A scoping review [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: The Rise in Early-Onset Cancers—Knowledge Gaps and Research Opportunities; 2025 Dec 10-13; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(23_Suppl):Abstract nr B013.

ObjectiveTo determine the characteristics and spatiotemporal distribution of major gastrointestinal (GI) neoplasms in inpatients from 1995 to 2016 in Wuwei city, northwestern China.MethodData from all paper and electronic medical records entered between 1995 and 2016 at 12 major public hospitals in Wuwei city were retrospectively collected. Patients with GI neoplasms were identified and classified according to the International Classification of Diseases (ICD)-10. Trends in the incidence of major GI neoplasms were expressed as an annual percentage change (APC), and the Z test was used to assess the time fluctuation trends. Age-standardized incidence rates (ASIRs) were also calculated and the corresponding APC was estimated by the Joinpoint software for long-term trend analysis. Thematic maps of annual incidence at the township level were produced.ResultsAmong the 19,137 new inpatients identified with GI neoplasms in Wuwei, gastric cancer was the leading cause of morbidity, followed by cancers of the esophagus, colorectum, gastric cardia, liver, and pancreas with ASIRs of 21.8, 11.0, 5.8, 5.7, 4.4, and 1.7 per 100,000 person-years, respectively. Overall, there was a steady increase in the ASIR for all GI neoplasms, and male cases were 2.1 times more frequent than female cases. The ASIR significantly increased by 12.2% per year from 1995 to 2009 for all GI neoplasms, and the increase rates ranged 9.4%-16.7% per year for the individual GI neoplasm. Despite an increase by 1.4% per year from 2009 to 2016, the ASIR decreased for esophageal and gastric cardia cancers by 4.6% and 17.3% per year, respectively. The annual incidence of all GI neoplasms showed significantly differential geographic distributions among different townships of the city during the study period.

222 Background: Gastrointestinal (GI) cancers account for nearly 20% of all cancers in the United States (US), with colorectal (CRC) and pancreatic cancers as leading causes of cancer-related deaths. While most GI cancer cases are sporadic, a significant subset are linked to inherited mutations that increases a person’s risk of cancer. Early identification of pathogenic germline variants is critical for informing personalized surveillance and preventive strategies, guiding cascade testing, and optimizing targeted therapies. Over 25 million people in the US have limited English proficiency (LEP), a population known to experience worse cancer care outcomes. Less is known whether disparities in germline testing uptake exist by language preference amongst patients with GI cancers. Methods: We conducted an IRB-approved retrospective study from 2019 to 2024, at a single academic center, including patients aged ≥18 years with GI cancers (pancreatic, gastric, or CRC) who met criteria for germline genetic testing (age < 50, MSI-H status, or suspected pathogenic mutations on tumor NGS). We evaluated if language preference (English vs Non-English) was associated with genetic testing uptake. We used logistic regressions to calculate odds ratios adjusting for age, gender, race/ethnicity, and insurance. Results: A total of 4,584 patients with GI cancers were included in the analysis. Of the 2,907 patients with pancreatic cancer, median age was 69, most were male (n = 1490, 51.3%), Non-Hispanc White (NHW) (n = 2104, 72.4%) and on Medicare/Medicaid (n = 1925, 66.3%). Of the 195 patients with gastric cancer, median age was 43, most were male (n = 107, 54.8%), NHW (n = 109, 55.9%) and on private insurance (n = 132, 67.7%). Of the 1,482 patients with CRC, median age was 44, most were female (n = 746, 51%), NHW (n = 912, 61.5%) and on private insurance (n = 1079, 72.8%). Among all 4,584 patients, 971 (21.2%) underwent germline genetic testing. Testing completion rates varied by cancer type: pancreatic (19.7%), gastric (20%), and colorectal (24.3%). For patients diagnosed with pancreatic or colorectal cancer, non-English speaking patients had lower odds of completing testing compared to English speaking patients (see Table 1). Conclusions: This study shows that, despite guideline recommendations, germline genetic testing rates are critically low among patients with pancreatic, gastric, and colorectal cancer. Disparities in genetic testing uptake exist among LEP patients. Targeted interventions are urgently needed to improve genetic testing uptake, especially among this vulnerable population. Odds ratio for genetic testing completion among non-English speakers compared to English-speakers. Cancer Type Language Genetic TestingOdd Ratio (95% CI) Pancreatic English Ref Non-English 0.55 (0.33-0.94) Gastric English Ref Non-English 0.88 (0.21-3.78) Colorectal English Ref Non-English 0.35 (0.14-0.87)

Purpose:This study aims to determine the incidence, histology, clinical extent of disease, and trends of gastrointestinal (GI) cancers in India. Methods:GI cancer cases diagnosed between 2012-2016 from 28 Population-Based Cancer Registries and 58 Hospital Based Cancer Registries under the National Cancer Registry Programme were included. Crude incidence rate and age-standardized incidence rates (AARs) were calculated. Joinpoint regression program, 4.0.1 was used for trend analysis for data from 1982 to 2016, and a P-value of <<0.05 was considered statistically significant. Results:GI cancers’ occurrence was more common among men (60.5%) than in women (39.5%). The incidence of GI cancer was highest in India’s northeast region, Aizawl district (AAR 126.9) among males, and in Papumpare district (AAR 75.9) among females. The commonest cancer among men was cancer of the esophagus (28.2%), followed by stomach cancer (21%) and rectum cancer (14.3%). Among women, cancer of the esophagus (25.7%), gallbladder (23.8%), stomach (14.8%), and rectum (14.6%) were common. Adenocarcinoma (57.83%) was the commonest type of GI tumors, followed by Squamous Cell neoplasms (25.99%). Majority of the GI cancers presented at the locoregional stage, but cancer of the gall bladder and pancreas presented at advanced stages. A rising trend for cancers of the colon, rectum, liver, gall bladder, pancreas was seen, while a declining trend was observed for stomach and oesophageal cancer. Conclusion:Our study highlights an increasing magnitude of GI cancers across different regions of India. Cancer registries form an essential tool for surveillance of GI cancers thus guiding prevention, early detection, and control programs.

Gastrointestinal (GI) cancers are a significant global health concern with diverse etiologies and limited treatment options. Ellagic acid (EA), a natural polyphenolic compound, exhibits promising anticancer properties against various GI malignancies. In this article, we have reviewed recent research on the anticancer potential of EA across esophageal, gastric, colorectal, pancreatic, and liver cancers. In esophageal cancer, EA inhibits the formation of O6-methylguanine (O6-meGua) adducts induced by carcinogens like N-nitrosomethylbenzylamine (NMBA), thereby suppressing tumor growth. Additionally, EA inhibits STAT3 signaling and stabilizes tumor suppressor proteins, showing potential as an anti-esophageal cancer agent. In gastric cancer, EA regulates multiple pathways involved in cell proliferation, invasion, and apoptosis, including the p53 and PI3K-Akt signaling pathways. It also demonstrates anti-inflammatory and antioxidant effects, making it a promising therapeutic candidate against gastric cancer. In colorectal cancer (CRC), EA inhibits cell proliferation, induces apoptosis, and modulates the Wnt/β-catenin and PI3K/Akt pathways, suggesting its efficacy in preventing CRC progression. Furthermore, EA has shown promise in pancreatic cancer by inhibiting nuclear factor-kappa B, inducing apoptosis, and suppressing epithelial–mesenchymal transition. In liver cancer, EA exhibits radio-sensitizing effects, inhibits inflammatory pathways, and modulates the tumor microenvironment, offering potential therapeutic benefits against hepatocellular carcinoma. Studies on EA potential in combination therapies and the development of targeted delivery systems are required for enhanced efficacy against gastrointestinal cancers.

Hereditary gastrointestinal cancers: why genetic counseling matters.

IL-6 gene polymorphisms can play a role in the development or control of cancer by affecting cytokines. Gastrointestinal cancer is one of the most common types of cancer worldwide. The aim of this study was to investigate the effect of polymorphism of the IL-6 174G > C gene on gastrointestinal cancers based on a systematic review and meta-analysis, including gastric, colorectal, and esophageal cancer. In this study, a systematic and meta-analytical review of the study data on the effect of polymorphism of IL-6 174G > C gene on gastrointestinal cancer (gastric, colorectal, and esophageal cancer) in Scopus, EMBASE, Web of Science, PubMed, and Science Direct Databases was extracted without any time limit until April 2020. In order to perform the analysis of eligible studies, the model of random effects was used and the heterogeneity of studies was investigated with I2 index. Data analysis was performed with Comprehensive Meta-Analysis software (Version 2). The total number of surveyed studies in patients with colorectal cancer was 22 studies. Based on the results of meta-analysis, the odds ratio of GG genotype in patients with colorectal cancer was 0.88. The odds ratio of GC genotype obtained in patients with colorectal cancer was 0.88 and the odds ratio of CC genotype in patients with colorectal cancer was 0.92. The total number of surveyed studies in patients with gastric cancer was 12. Based on the meta-analysis results, the odds ratio of GG genotype in patients with gastric cancer was 0.74, the odds ratio of GC genotype in patients with gastric cancer was 1.27, and the odds ratio of CC genotype in patients with gastric cancer was 0.78. The total number of surveyed studies in esophageal cancer patients was 3 studies. Based on the results of meta-analysis, the odds ratio of GG genotype in patients with esophageal cancer was 0.57, the odds ratio of GC genotype in patients with esophageal cancer was 0.44, and the odds ratio of chance of CC genotype in patients with esophageal cancer was 0.99. In general, different genotypes of polymorphism of the IL-6 174G > C gene reduce the risk of gastric, colorectal, and esophageal cancer. However, the GC genotype of this gene was associated with a 27% increased risk of gastric cancer.