Early onset cancer in Chile: 27-year mortality rate trends from a nationwide database with focus in gastrointestinal tumors.

Abstract

11169 Background: Cancer has historically been considered a disease of older adults, however, several reports have shown an alarming rise in the incidence of early onset cancer, particularly gastrointestinal tumors and specially colorectal cancer. To date, there are no reports in this field from Latin America. This study aims to evaluate the trends in mortality rates of the most relevant gastrointestinal tumors among young versus older people in Chile. Methods: Nationwide data from the National Department of Statistics and Health Information was obtained from the years 1997 to 2023. Cause Specific Mortality was analysed for all ages, older ( ≥ 50 years) and younger (<50 years) patients for all tumors, Colorectal, Gastric, Esophagus, Pancreas, Liver and Biliary Tract cancer. The trends of rates were analyzed using Joinpoint Trend Analysis Software for calculation of the annual percentage rate change (APC). Results: Cancer-related mortality in Chile is increasing. From 1997 to 2023, for all causes, there were 2,645,132 deaths, the APC for the overall population, for all cancers is 0.96% (0.63%-1.29%, p<0.001). Gastrointestinal cancer accounted for 10%, with 261,300 deaths. When analyzed by type of cancer, an increase in mortality for colorectal cancer was observed, with a rate increase 90.5% higher in younger than older adults, with an APC of 3.24% and 1.7%, respectively. This difference was more evident in female adults. Pancreatic cancer mortality rate increased from 1997 to 2015 with an APC of 0.96% in older patients, but decreased from 2015 to 2023 with an APC of -0.87%. The mortality was steady in younger patients. No differences between younger and older patients were seen for Stomach, Esophagus, Biliary tract and Liver Cancer. Stomach cancer mortality rate has decreased in younger and older patients, with an APC of -1.61% and -2.63% respectively for the period from 1997 to 2015, and -5.87% and -4.77% respectively for the period from 2015 to 2023. Esophagus cancer mortality rate has decreased in younger and older patients, with an APC of -1.09% and -2.7% respectively for the period from 1997 to 2006, and -7.71% and -4.58% respectively for the period from 2006 to 2023. Biliary tract cancer mortality rate has decreased in younger and older patients, with an APC of -1.27% and -1.61% respectively for the period from 1997 to 2006, and -7.49% and -3.39% respectively for the period from 2006 to 2023. Liver cancer mortality rate has decreased in younger and older patients, with an APC of -2.53% for younger patients and -0.13% for older patients in the period from 1997 to 2015, and -2.43% respectively for the period from 2015 to 2023. Conclusions: This study shows an increase in mortality rates of colorectal cancer among young adults that almost doubles the rate increase in older adults in Chile. Efforts to raise awareness and improve access to early detection and healthcare should be prioritized.