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Global study reveals 30-year trends in GI cancers, IBD
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A global study that spanned nearly 30 years in 195 countries has revealed different shifts in the trend of incidence and death rates of several gastrointestinal cancers, as well as the global burden of inflammatory bowel disease, according to data presented at UEG Week.
The Global Burden of Disease study, authored by Reza Malekzadeh, MD, professor of internal medicine and gastroenterology at Tehran University of Medical Sciences in Iran, and colleagues, explored the incidence, mortality and disability caused by colorectal cancer, gastric cancer, pancreatic cancer and IBD from 1990 to 2017.
“This analysis provides the most comprehensive picture of the global burden of digestive disease to date,” Herbert Tilg, of Innsbruck Medical University in Austria and chair of the UEG scientific committee, said in a press release. “Examining these cross-population trends offers vital information on the changing burden of disease and aids the correct allocation of resources to improve patient outcomes.”
Pancreatic cancer
Malekzadeh and colleagues found there were approximately 441,000 deaths from pancreatic cancer in 2017, a 2.3-fold increase on the number of deaths reported in 1990 (196,000). They observed the highest death rates in high-income regions, with the highest rates found in Greenland (17.4 per 100,000 person-years) and Uruguay (12.1 per 100,000 person-years.
The increase could be tied to a rise in obesity and diabetes, the researchers said. They also identified smoking, high fasting plasma glucose and high BMI as risk factors.
A global study that spanned nearly 30 years in 195 countries has revealed different shifts in the trend of incidence and death rates of several gastrointestinal cancers, as well as the global burden of inflammatory bowel disease, according to data presented at UEG Week. Adobe Stock
“Pancreatic cancer is one of the world’s deadliest cancers, with an overall 5-year survival rate of just 5% in high, middle and low-income countries,” Malekzadeh said in the release. “Major risk factors for the disease, such as smoking, diabetes and obesity, are largely modifiable and present a huge opportunity for prevention.”
Colorectal cancer
Investigators also saw a rise in the incidence rate of CRC, which increased 9.5% from 1990 to 23.3 per 100,000 person-years in 2017. However, the standardized death rate of 11.5 per 100,000 person-years in 2017 was down 13.5% from the rate in 1990. Researchers attributed this decrease in death rates to early detection through the establishment of CRC screening programs.
Malekzadeh and colleagues found that risk factors differed between men and women. In men, alcohol use, smoking and diets low in calcium, milk and fiber had the highest burden, while dietary risks, but not smoking or alcohol use, were the biggest risk factors in women.
Gastric cancer
Despite increased absolute numbers, the age-standardized incidence and deaths rates for gastric cancer both steadily declined since 1990 to rates of 15.4 and 11 per 100,000 person-years, respectively. Researchers wrote that the burden is highest in east Asia, and local strategies are needed to fit risk factors in each country.
“This research shows how gastric cancer presents vast geographical variations, and understanding these differential trends is essential for formulating effective preventive strategies,” Malekzadeh said in the release. “Beyond the current decline in incidence and death rates, a decrease in the absolute number of cases and deaths will be possible if the burden in east Asia, where currently almost half of the cases and deaths occur, is further reduced.”
IBD
In IBD, the age-standardized prevalence rate increased from 79.5 per 100,000 person-years in 1990 to 84.3 per 100,000 person-years in 2017, while the death rate decreased from 0.62 per 100,000 person years to 0.51 per 100,000 person-years.
The highest prevalence rates were found in the United States (438.6 per 100,000 person-years) and the United Kingdom (449.6 per 100,000 person years).
Malekzadeh and colleagues wrote that the increased prevalence of IBD is expected to continue in the future.
“Rising prevalence, plus the increase in incidence in historically low-incidence regions, will have important health and economic effects,” they wrote. “Our findings could be useful for health service planners and policy makers to justify and prioritize resource allocation to be able to respond to the growing number of patients with IBD.” – by Alex Young
Disclosure s: Malekzadeh reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.
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GBD 2017 Colorectal Cancer Collaborators. Lancet Gastroenterol Hepatol. 2019;doi:10.1016/S2468-1253(19)30345-0.
GBD 2017 Inflammatory Bowel Disease Collaborators. Lancet Gastroenterol Hepatol. 2019;doi:10.1016/S2468-1253(19)30333-4.
GBD 2017 Pancreatic Cancer Collaborators. Lancet Gastroenterol Hepatol. 2019;doi:10.1016/S2468-1253(19)30347-4.
GBD 2017 Stomach Cancer Collaborators. Lancet Gastroenterol Hepatol. 2019;doi:10.1016/S2468-1253(19)30328-0.
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