Mortality of Gastrointestinal Cancers Attributable to Smoking, Alcohol, and Metabolic Risk Factors, and its Association With Socioeconomic Development Status 2000-2021 - 28/02/25

Doi : 10.1016/j.amjmed.2024.12.019

Pojsakorn Danpanichkul, MD ^a,^{^{#
P.D., K.S. and Y.P. these are co-first authors.}}, Kanokphong Suparan, MD ^b,^{^{#
P.D., K.S. and Y.P. these are co-first authors.}}, Yanfang Pang, MSc ^c,^d,^e,^f,^{^{#
P.D., K.S. and Y.P. these are co-first authors.}}, Thanida Auttapracha, MD ^g, Ethan Kai Jun Tham, MD ⁱ, Karan Srisurapanont, MD ^j, Ekdanai Uawithya, MD ^k, Rinrada Worapongpaiboon, MD ^l, Tanawat Attachaipanich, MD ^m, Ryan Yan Zhe Lim, MD ^h, Mazen Noureddin, MD, MHSc ⁿ, Amit G. Singal, MD ^o, Suthat Liangpunsakul, MD, MPH ^p,^q,^r, Michael B. Wallace, MD, MPH ^s, Ju Dong Yang, MD, MSc ^t,^{^{+
J.D.Y and K.W. these are co-senior authors.}}, Karn Wijarnpreecha, MD, MPH ^u,^v,^w,^⁎,^{^{+
J.D.Y and K.W. these are co-senior authors.}}
^a Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
^b Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
^c Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China
^d National Immunological Laboratory of Traditional Chinese Medicine, Guangxi, China
^e Key Laboratory of Research on Clinical Molecular Diagnosis for High Incidence Diseases in Western Guangxi, Guangxi, China
^f Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
^g Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
^h Yong Loo Lin School of Medicine, National University of Singapore, Singapore
ⁱ Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
^j Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai
^k Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
^l Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
^m Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
ⁿ Houston Research Institute and Houston Methodist Hospital, Houston, Texas
^o Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas
^p Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
^q Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana
^r Roudebush Veterans' Administration Medical Center, Indianapolis, Indiana
^s Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
^t Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, and Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
^u Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona
^v Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona
^w BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona

^⁎Requests for reprints should be addressed to Karn Wijarnpreecha, MD, MPH, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, ArizonaDivision of Gastroenterology and HepatologyDepartment of Internal MedicineBanner University Medical CenterPhoenixArizona

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Friday 28 February 2025

Abstract

Objective

Gastrointestinal (GI) cancers account for one-third of global cancer mortality, with nearly half being preventable. This study updates the global burden of GI cancers attributed to major risk factors.

Methods

We utilized data from the Global Burden of Disease Study 2021 to examine trends in death and age-standardized death rates related to GI cancers caused by smoking, alcohol, high body mass index (BMI), and high fasting blood glucose (FBG) from 2000 to 2021. Trends were analyzed based on countries' developmental status using a sociodemographic index (SDI).

Results

In 2021, there were 1.12 million GI cancer deaths related to smoking, alcohol, high BMI, and high FBG, which was 53.6% higher than in 2000. The largest proportion of GI cancer mortality was attributed to smoking (43.3%), followed by alcohol (20.6%), high FBG (20.5%), and high BMI (15.6%). The increases in GI cancer deaths between 2000 and 2021 were related to high BMI (+102.54%) and FBG (+107.69%), particularly in liver and pancreatic cancer. In 2021, GI cancer mortality in low, low-middle, and middle SDI countries represented 44.3% of the global GI cancer mortality attributed to smoking, 41.9% for alcohol, 34.3% for high BMI, and 31.6% for high FBG. Since 2000, these proportions have increased by +4.5% for smoking, +7.6% for alcohol, + 12.3% for high BMI, and +6.4% for high FBG.

Conclusion

From 2000 to 2021, GI cancer mortality increased substantially, driven primarily by obesity and alcohol. Lower SDI countries are increasingly contributing to the global GI cancer burden.

El texto completo de este artículo está disponible en PDF.

Keywords : Cancer, Epidemiology, Gastroenterology, Obesity, Oncology, Public health

Abbreviation : APC, ASDR, BMI, CI, FBG, GBD, SDI, UI

Esquema

Introduction

Methods

Overview, Definition, and Measures

Data and Statistical Analysis

Results

Global Mortality of Gastrointestinal Cancer

Global Mortality of Gastrointestinal Cancer From Modifiable Risk Factors

Mortality of Gastrointestinal Cancer From Smoking

Mortality of Gastrointestinal Cancer From Alcohol

Mortality of Gastrointestinal Cancer From High Body Mass Index

Mortality of Gastrointestinal Cancer From High Fasting Blood Sugar

Proportion of Gastrointestinal Cancer in Low, Low-Middle, and Middle SDI, Relative to the Global Burden

Discussion

	Funding: No external funding was received for this study.
	Conflict of Interest: Mazen Noureddin has been on the advisory board for 89BIO, Gilead, Intercept, Pfizer, Novo Nordisk, Blade, EchoSens, Fractyl, Terns, Siemens, and Roche diagnostic; has received research support from Allergan, BMS, Gilead, Galmed, Galectin, Genfit, Conatus, Enanta, Madrigal, Novartis, Pfizer, Shire, Viking and Zydus; and is a minor shareholder or has stocks in Anaetos, Rivus Pharma and Viking. Amit Singal has served as a consultant or on advisory boards for FujiFilm Medical Sciences, Exact Sciences, Glycotest, Roche, Abbott, DELFI, GRAIL, Genentech, AstraZeneca, Eisai, Bayer, Exelixis, Merck, Elevar, Boston Scientific, Sirtex, and HistoSonics.
	Authorship: PD: Writing–review & editing, Writing–original draft, Visualization, Validation, Supervision, Project administration, Methodology, Formal analysis, Data curation, Conceptualization; KS: Writing–original draft, Data curation, Conceptualization; YP: Writing–original draft, Methodology; TA: Writing–original draft, Validation; EKJT: Writing–original draft, Validation; CV: Writing–original draft, Software, Data curation; KS: Writing–original draft, Supervision, Methodology; EU: Writing–original draft; RW: Writing–original draft, Validation; TA: Writing–original draft, Methodology; RYZL: Validation, Methodology; MN: Writing–review & editing, Supervision; AGS: Writing–review & editing, Methodology; SL: Writing–review & editing, Supervision, Conceptualization; MBW: Writing–review & editing, Supervision; JDY: Writing–review & editing, Supervision, Conceptualization; KW: Writing–review & editing, Conceptualization.