BACKGROUND and Importance: Growing gastrointestinal cancers in the U.S. necessitate further research due to substantial healthcare and economic impacts. This study aims to analyze trends and future projections for five major gastrointestinal cancers (colorectal, pancreatic, liver, stomach, and esophageal). METHODS Data were sourced from the Surveillance, Epidemiology, and End Results database, National Center for Health Statistics, and Global Burden of Diseases databases. An age-period-cohort model utilizing the Bayesian Information Criterion method was applied to project incidence and mortality rates to 2040. RESULTS Males consistently exhibited higher incidence and mortality rates across all gastrointestinal cancers, with significant variation across the 51 U.S. states. From 2000 to 2020, colorectal cancer incidence and mortality rates declined across all racial groups, except for the incidence rates of American Indian and Alaska Native (AIAN) men, Hispanic men, and Hispanic women, which remained stable. Pancreatic cancer incidence increased across all groups except for AIAN men, while mortality rates rose only for White men and Hispanic women. Liver cancer incidence rose among AIAN men and White, AIAN, and Hispanic women, while mortality rates declined for most groups. Stomach cancer incidence and mortality either declined or stabilized, and esophageal cancer rates showed a general decline. By 2040, increases in incidence and mortality are projected for most gastrointestinal cancers, particularly in men. CONCLUSIONS Despite varied trends over the past two decades, an overall increase in gastrointestinal cancer incidence and mortality rates is anticipated in the next 20 years in the U.S., underscoring the need for effective prevention and intervention strategies.

中文翻译：

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美国胃肠道癌发病率、死亡率的差异、趋势和到 2040 年的预测。


背景和重要性： 由于对医疗保健和经济的重大影响，美国胃肠道癌症的增长需要进一步的研究。本研究旨在分析五种主要胃肠道癌症（结直肠癌、胰腺癌、肝癌、胃癌和食管癌）的趋势和未来预测。方法 数据来源于监测、流行病学和最终结果数据库、国家卫生统计中心和全球疾病负担数据库。利用贝叶斯信息标准方法的年龄-时期-队列模型应用于预测到 2040 年的发病率和死亡率。结果 在所有胃肠道癌症中，男性的发病率和死亡率始终较高，在美国 51 个州之间存在显着差异。从 2000 年到 2020 年，所有种族群体的结直肠癌发病率和死亡率都有所下降，但美洲印第安人和阿拉斯加原住民 （AIAN） 男性、西班牙裔男性和西班牙裔女性的发病率保持稳定。除 AIAN 男性外，所有群体的胰腺癌发病率均有所增加，而仅白人男性和西班牙裔女性的死亡率上升。AIAN 男性和白人、AIAN 和西班牙裔女性的肝癌发病率上升，而大多数群体的死亡率下降。胃癌发病率和死亡率下降或稳定，食管癌发病率普遍下降。到 2040 年，预计大多数胃肠道癌症的发病率和死亡率将增加，尤其是男性。结论 尽管过去二十年的趋势各不相同，但预计未来 20 年美国胃肠道癌发病率和死亡率将总体增加，这凸显了有效预防和干预策略的必要性。