{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:19:20Z","timestamp":1787663960561,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Smoking is a major modifiable risk factor for upper gastrointestinal cancers (UGIC), particularly in China. This study investigated temporal trends, demographic patterns, and future projections of smoking\u2010attributable UGIC mortality globally and nationally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We extracted data from the Global Burden of Disease 2021. Joinpoint regression was used to assess trends in smoking\u2010attributable UGIC mortality rates and absolute deaths. Age\u2010period\u2010cohort (APC) model was applied to evaluate effects brought by age groups and birth cohort. Decomposition analysis quantified contributions of aging, population growth, and epidemiologic shifts to mortality changes. Bayesian APC (BAPC) model projected mortality trends to 2030.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At the population level, smoking is more strongly associated with esophageal cancer than gastric cancer. Although smoking\u2010attributable mortality rates of both esophageal and gastric cancers declined globally and in China, the decline was more pronounced for gastric cancer than for esophageal cancer (AAPC: \u22122.594 vs. \u22121.229 globally; \u22122.297 vs. \u22121.491 in China; both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). However, trends in absolute deaths differed by cancer type and geography: smoking\u2010attributable esophageal cancer deaths increased globally and in China, whereas smoking\u2010attributable gastric cancer deaths increased in China but remained stable globally. APC analysis revealed the most significant drop among young adults aged 35\u201344, but mortality trends plateaued or increased in older individuals. In contrast, esophageal cancer mortality is expected to remain elevated through 2030, with an estimated 263,219 deaths globally including 187,567 in China.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite declining mortality rates, the absolute number of smoking\u2010related UGIC deaths remains substantial and is rising in China due to demographic momentum. Greater reductions were seen among young individuals and females. These ecological findings underscore the importance of strengthening tobacco\u2010control policies to mitigate the population\u2010level burden attributable to smoking, particularly within high\u2010risk populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72198","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T03:23:03Z","timestamp":1787109783000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age\u2010Period\u2010Cohort Analysis and Projections of Smoking\u2010Attributable Upper Gastrointestinal Cancers Burden: A Comparative Study of China and the World"],"prefix":"10.1002","volume":"15","author":[{"given":"Yunhao","family":"Li","sequence":"first","affiliation":[{"name":"Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine The University of Hong Kong, Hong Kong Special Administrative Region (SAR)  China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine The University of Hong Kong, Hong Kong Special Administrative Region (SAR)  China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man Ping","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Nursing, Li Ka Shing Faculty of Medicine The University of Hong Kong, Hong Kong Special Administrative Region (SAR)  China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8336-5552","authenticated-orcid":false,"given":"Wen\u2010Qing","family":"Li","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Cancer Epidemiology Peking University Cancer Hospital &amp; Institute  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai. 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