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

Gastrointestinal (GI) cancer poses a significant burden in the Asia-Pacific region. Growing and aging populations, cancer prevention efforts, and treatment advances have all influenced GI cancer trends. This review provides an updated overview of GI cancer epidemiology in the region, using age-standardized incidence rates (ASIRs) and death rates (ASDRs) from the Global Burden of Disease 2021 and the Global Cancer Observatory 2022. Differences between the two datasets should be interpreted with consideration of variations in methodology, standard populations, and reporting years. Colorectal cancer ranks highest in all regions across both datasets for ASIR. However, ASDR is less uniform. There is geographic heterogeneity in GI cancer burden, with Mongolia disproportionately impacted by esophageal, gastric, and liver cancers, while Japan and Australia have a considerable burden of colorectal and pancreatic cancers, along with gastric cancer in Japan. Lower mortality-to-incidence ratios for colorectal and gastric cancers may reflect the effective implementation of screening programs, facilitating early detection and effective treatments. Conversely, esophageal, pancreatic, and gallbladder cancers have lower ASIRs but incidence-to-mortality ratio near one, likely reflecting lack of cost-effective screening and poor prognosis with late-stage diagnoses. Several South-East Asian and Pacific Island countries with lower socioeconomic status show markedly lower ASIRs and ASDRs, which may reflect differences in data availability, reporting, and healthcare access, highlighting the need to strengthen national cancer registry systems. Altogether, this review offers up-to-date GI cancer epidemiology insights to support healthcare providers and policymakers in developing targeted strategies to reduce the burden of GI cancer in the Asia-Pacific region.