Global status and attributable risk factors of esophageal, stomach, colorectal cancers in adolescents and young adults: global burden of disease 2021 study analysis.

[BACKGROUND AND AIMS] Digestive tract cancers, encompassing esophageal, stomach, colorectal cancers, account for about 20% of all cancer cases worldwide. This study seeks to examine the global epidemiological trends of these cancers in adolescents and young adults (AYA) from 1990 to 2021, as well as the related risk factors, to offer valuable insights for the formulation of health policies and the efficient distribution of public health resources.

[METHODS] Data from the Global Burden of Disease 2021 (GBD 2021) were utilized to conduct a comprehensive assessment of the global incidence, death, and disability-adjusted life years (DALYs) of digestive tract cancers within the AYA population. The correlation between cancer burden and socioeconomic development was examined by Socio-Demographic Index (SDI) regions. Use comparative risk assessment from GBD to evaluate risk factors for cancer deaths and DALYs. Assess incidence trends with BAPC model.

[RESULTS] The global burden of digestive tract cancer increased at different rates from 1990 to 2021. In 2021, colorectal cancer in AYA accounted for 70,201 incidences, 26,222 deaths, and 1,538,837 DALYs worldwide. In contrast, esophageal and stomach cancer had lower burdens in 8,164 and 42,039 incidences, respectively. While the incidence and death rates of esophageal and stomach cancers have declined, colorectal cancer have shown a significant increase in AYA. The age-standardized incidence rate (ASIR) of colorectal cancer correlates positively with SDI. In AYA, level 2 risk factors for colorectal cancer include alcohol use, dietary risks, high body mass index, high fasting plasma glucose, low physical activity, and tobacco. For esophageal cancer, the risk factors are alcohol use, dietary risks, and tobacco, and for stomach are dietary risks and tobacco. By 2040, the ASIR of the three digestive tract cancers in AYA will all decrease according to the BAPC model prediction.

[CONCLUSION] The study of digestive tract cancers in AYA serves to identify risk factors within the realm of public health, facilitate the rational allocation of medical resources. Moreover, it can attend to the physical and mental health requirements of AYA individuals and enhance the cognitive framework regarding cancer.