Global incidence, mortality, and projections of early-onset upper gastrointestinal cancers.

Abstract

e16339 Background: Cancers of the upper gastrointestinal tract remain major contributors to morbidity and mortality worldwide, yet global patterns in early-onset (EO) disease (age < 50 years) remain poorly characterized. We sought to examine the contemporary global incidence and mortality and analyse expected burden through 2045 using a large population-level database. Methods: GLOBOCAN 2022 was queried for men and women aged 20–49 years with esophageal and gastric cancers. Outcomes were incident cases, deaths, age-standardized incidence and mortality rates (ASR), crude rates, and cumulative risk. Factors were adjusted for populations. Estimates were stratified by continent and HDI. Burden through 2045 was estimated using GLOBOCAN projections, with changes decomposed into population growth/aging and risk effects according to standard GLOBOCAN methodology. Results: In 2022, 80,885 EO gastric cancer cases (ASR 2.4) and 51,259 deaths (ASR 1.6) were estimated globally, while 45,056 EO esophageal cancer cases (ASR 1.4) and 39,196 deaths (ASR 1.2) were projected. The largest share of cases and mortality was in Asia (Table). By HDI, EO gastric cancer incidence (36,170 cases; ASR 2.9) and mortality (21,818 deaths; ASR 1.7) peaked in high-HDI countries, while esophageal cancer incidence and mortality were highest in medium-HDI countries (23,488 cases and 22,734 deaths; both ASR 2.5). From 2022 to 2045, EO esophageal and gastric cancer incidence and mortality are projected to increase across all continents except Europe. Conclusions: EO esophageal and gastric cancers contribute a substantial and uneven global burden, with marked geographic and HDI-related heterogeneity. Incidence and mortality are expected to rise sharply in low- and middle-HDI regions (particularly Africa), while declining in Europe through 2045. Region-specific prevention strategies and health-system preparedness are needed to address the growing burden of early-onset upper gastrointestinal cancers. Incidence and Mortality of Early onset Esophageal and Stomach Cancer (Age 20–49, Both Sexes, 2022-2045). Continent Esophagus Incidence 2022 Esophagus Incidence 2045 %Δ Esophagus Mortality 2022 Esophagus Mortality 2045 %Δ Stomach Incidence 2022 Stomach Incidence 2045 %Δ Stomach Mortality 2022 Stomach Mortality 2045 %Δ Africa 5,979 11,075 +85.2% 5,101 9,446 +85.2% 7,278 13,432 +84.6% 5,828 10,750 +84.5% Asia 33,539 37,242 +11.0% 29,968 33,326 +11.2% 54,869 60,071 +9.5% 33,546 36,764 +9.6% Europe 2,732 2,206 −19.3% 2,011 1,623 −19.3% 7,803 6,265 −19.7% 4,572 3,667 −19.8% Latin America & Caribbean 1,756 2,089 +19.0% 1,383 1,655 +19.7% 7,716 8,682 +12.5% 6,081 6,819 +12.1% Northern America 957 1,131 +18.2% 674 797 +18.2% 2,925 3,366 +15.1% 1,109 1,276 +15.1% Oceania 93 125 +34.4% 59 80 +35.6% 294 385 +31.0% 123 161 +30.9% Global total (sum of regions) 45,056 53,868 +19.6% 39,196 46,927 +19.7% 80,885 92,201 +14.0% 51,259 59,437 +16.0%