Burden landscape of hepatobiliary and pancreatic cancers in Chinese young adults: 30 years’ overview and forecasted trends

doi:10.4251/wjgo.v16.i10.4177

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World Journal of Gastrointestinal Oncology

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Clinical and Translational Research

World J Gastrointest Oncol. Oct 15, 2024; 16(10): 4177-4193
Published online Oct 15, 2024. doi: 10.4251/wjgo.v16.i10.4177

Burden landscape of hepatobiliary and pancreatic cancers in Chinese young adults: 30 years’ overview and forecasted trends

De-Sheng Chen, Ze-Ping Chen, Dong-Zi Zhu, Lv-Xin Guan, Qi Zhu, Yi-Chao Lou, Ze-Ping He, Hao-Nan Chen, Hong-Cheng Sun

De-Sheng Chen, Ze-Ping Chen, Qi Zhu, Yi-Chao Lou, Ze-Ping He, Hong-Cheng Sun, Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China

Dong-Zi Zhu, Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

Lv-Xin Guan, Shenzhen Institute of Translational Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, Guangdong Province, China

Hao-Nan Chen, Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China

Co-first authors: De-Sheng Chen and Ze-Ping Chen.

Co-corresponding authors: Hao-Nan Chen and Hong-Cheng Sun.

Author contributions: Chen DS, Chen ZP and Zhu DZ curated the data; Guan LX and Zhu Q conducted the formal analysis, with Lou YC and He ZP contributing to the methodology; Chen DS and Chen ZP visualized the results. Chen DS and Zhu DZ wrote the original draft; All authors have reviewed and approved the final manuscript. Chen DS and Chen ZP contributed equally to this study as co-first authors. Both Sun HC and Chen HN have played important and indispensable roles in the project conception, data interpretation and manuscript preparation as the co-corresponding authors. Sun HC conceptualized, designed, and supervised the whole process of the project. Chen HN was responsible for guiding data re-analysis and re-interpretation, figure plotting, preparation and submission of the current version. This collaboration between Sun HC and Chen HN is crucial for the publication of this manuscript.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Hong-Cheng Sun, MD, PhD, Chief Doctor, Chief Physician, Surgeon, Surgical Oncologist, Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai 200080, China. hongcheng.sun@shgh.cn

Received: June 16, 2024
Revised: August 18, 2024
Accepted: August 28, 2024
Published online: October 15, 2024
Processing time: 101 Days and 15.3 Hours

Abstract

BACKGROUND

Hepatobiliary and pancreatic (HBP) cancers impose a considerable burden on young populations (aged 15 to 49 years), resulting in a substantial number of new cases and fatalities each year. In young populations, the HBP cancers shows extensive variance worldwide and the updated data in China is lacking.

AIM

To investigate the current status, trends, projections, and underlying risk factors of HBP cancers among young populations in China.

METHODS

The Global Burden of Disease Study 2019 provided data on the annual incidence, mortality, disability-adjusted life years (DALYs), age-standardized incidence rate (ASIR), mortality rate (ASMR), and DALYs rate (ASDR) of HBP cancers in young Chinese adults between 1990 and 2019. Temporal trends were assessed using estimated annual percentage change and hierarchical clustering. Sex-specific mortality and DALYs caused by various risks were analyzed across China and other regions, with future trends until 2035 projected using the Bayesian age-period-cohort model.

RESULTS

From 1990 to 2019, incident cases, deaths, DALYs, ASIR, ASMR, and ASDR for liver cancer (LC) in young Chinese individuals decreased, classified into 'significant decrease' group. Conversely, cases of gallbladder and biliary tract cancer and pancreatic cancer rose, categorized as either 'significant increase' or 'minor increase' groups. The contribution of risk factors to mortality and DALYs for HBP tumors increased to varying degrees. Healthy lifestyle behaviors, such as tobacco control, weight management, alcohol moderation, and drug avoidance, could lower HBP cancers incidence. Moreover, except for LC in females, which is likely to initially decline slightly and then rise, the forecasting model predicted that the ASIR and ASMR for all HPB cancers subtypes by gender will increase among young adults.

CONCLUSION

HBP cancers burden among young adults in China is expected to increase until 2035, necessitating lifestyle interventions and targeted treatment strategies to mitigate the public health impact of these cancers.

Keywords: Hepatobiliary and pancreatic cancers; Burden landscape; Young adults; Projection; China

Core Tip: The landscape of hepatobiliary and pancreatic (HBP) cancers among young adults (aged 15 to 49 years) in China was characterized by an overall increasing trend in addition to a substantial burden. This highlighted the persistently high prevalence of HBP malignancies. In general, adopting healthy lifestyle habits such as practicing tobacco control, maintaining a healthy weight, reducing alcohol consumption, and avoiding drug use could help decrease the risk of developing HBP cancers. These findings offered a comprehensive perspective for guiding healthcare approaches focused on primary prevention for Chinese youth.