Trends in early- and late-onset gastrointestinal cancer mortality in Spain, 1999-2023.

[BACKGROUND] this study analyses mortality trends in early-onset gastrointestinal cancers (EOGIC, < 50 years) in Spain between 1999 and 2023, comparing them with those of late-onset cancers (≥ 50 years).

[METHODS] data from the Spanish National Institute of Statistics were used to calculate age-standardized mortality rates. Joinpoint regression was applied to identify trend changes, reporting average annual percentage change (AAPC) and annual percentage change (APC), with 95 % confidence intervals.

[RESULTS] EOGIC mortality declined across most cancer sites and in both sexes. Among men, the largest decreases were observed in esophageal (-5.6 %) and stomach cancers (-4.0 %), followed by liver (-3.7 %) and colon (-3.2 %). In women, esophageal cancer showed the greatest reduction (-4.3 %), followed by colon (-2.6 %), stomach (-2.2 %), rectal and liver cancers. Pancreatic cancer mortality remained stable in younger women but began to decline from 2007 onwards (-1.2 %). In adults aged 50 and over, trends were more variable: pancreatic cancer mortality increased (men: +1.0 %; women: +1.6 %), while stomach cancer mortality declined (men: -3.3 %; women: -2.9 %). Colon cancer showed steeper declines from 2011-2012. Liver, rectal and other digestive cancers showed modest decreases. Esophageal cancer mortality declined in men but remained stable in women.

[CONCLUSION] EOGIC mortality in Spain declined steadily over the study period, whereas trends in late-onset cancers were more irregular. These findings highlight the need for age-specific cancer prevention and control strategies.