{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T03:06:17Z","timestamp":1789009577994,"version":"build-2803163510"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"},{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Dig Dis Sci"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1007\/s10620-026-10078-6","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T09:42:30Z","timestamp":1782466950000},"page":"5071-5082","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disease Burden of Early-Onset Pancreatic Cancer in Adults Aged 20\u201354 Years in Low- and Middle-Income Countries: A GBD 2023 Analysis"],"prefix":"10.1007","volume":"71","author":[{"given":"Shan","family":"Zhuang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peihua","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"10078_CR1","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3322\/caac.21763","volume":"73","author":"RL Siegel","year":"2023","unstructured":"Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA: a cancer journal for clinicians 2023;73:17\u201348. https:\/\/doi.org\/10.3322\/caac.21763.","journal-title":"CA: a cancer journal for clinicians"},{"key":"10078_CR2","doi-asserted-by":"publisher","first-page":"2008","DOI":"10.1016\/s0140-6736(20)30974-0","volume":"395","author":"JD Mizrahi","year":"2020","unstructured":"Mizrahi JD, Surana R, Valle JW, Shroff RT. Pancreatic cancer. Lancet (London, England) 2020;395:2008\u20132020. https:\/\/doi.org\/10.1016\/s0140-6736(20)30974-0.","journal-title":"Lancet (London, England)"},{"key":"10078_CR3","doi-asserted-by":"publisher","first-page":"5619","DOI":"10.7314\/apjcp.2015.16.14.5619","volume":"16","author":"V Goral","year":"2015","unstructured":"Goral V. Pancreatic Cancer: Pathogenesis and Diagnosis. Asian Pacific journal of cancer prevention\u202f: APJCP 2015;16:5619\u20135624. https:\/\/doi.org\/10.7314\/apjcp.2015.16.14.5619.","journal-title":"Asian Pacific journal of cancer prevention : APJCP"},{"key":"10078_CR4","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1001\/jama.2021.13027","volume":"326","author":"W Park","year":"2021","unstructured":"Park W, Chawla A, O\u2019Reilly EM. Pancreatic Cancer: A Review. Jama 2021;326:851\u2013862. https:\/\/doi.org\/10.1001\/jama.2021.13027.","journal-title":"Jama"},{"key":"10078_CR5","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1038\/s41575-018-0005-x","volume":"15","author":"JP Neoptolemos","year":"2018","unstructured":"Neoptolemos JP, Kleeff J, Michl P, Costello E, Greenhalf W, Palmer DH. Therapeutic developments in pancreatic cancer: current and future perspectives. Nature reviews Gastroenterology & hepatology 2018;15:333\u2013348. https:\/\/doi.org\/10.1038\/s41575-018-0005-x.","journal-title":"Nature reviews Gastroenterology & hepatology"},{"key":"10078_CR6","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1038\/s41575-021-00457-x","volume":"18","author":"AP Klein","year":"2021","unstructured":"Klein AP. Pancreatic cancer epidemiology: understanding the role of lifestyle and inherited risk factors. Nature reviews Gastroenterology & hepatology 2021;18:493\u2013502. https:\/\/doi.org\/10.1038\/s41575-021-00457-x.","journal-title":"Nature reviews Gastroenterology & hepatology"},{"key":"10078_CR7","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1053\/j.gastro.2020.10.007","volume":"160","author":"J Huang","year":"2021","unstructured":"Huang J, Lok V, Ngai CH, Zhang L, Yuan J, Lao XQ et al. Worldwide Burden of, Risk Factors for, and Trends in Pancreatic Cancer. Gastroenterology 2021;160:744\u2013754. https:\/\/doi.org\/10.1053\/j.gastro.2020.10.007.","journal-title":"Gastroenterology"},{"key":"10078_CR8","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.trstmh.2005.07.021","volume":"100","author":"A Boutayeb","year":"2006","unstructured":"Boutayeb A. The double burden of communicable and non-communicable diseases in developing countries. Transactions of the Royal Society of Tropical Medicine and Hygiene 2006;100:191\u2013199. https:\/\/doi.org\/10.1016\/j.trstmh.2005.07.021.","journal-title":"Transactions of the Royal Society of Tropical Medicine and Hygiene"},{"key":"10078_CR9","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1002\/ijc.31664","volume":"144","author":"S Pilleron","year":"2019","unstructured":"Pilleron S, Sarfati D, Janssen-Heijnen M, Vignat J, Ferlay J, Bray F et al. Global cancer incidence in older adults, 2012 and 2035: A population-based study. International journal of cancer 2019;144:49\u201358. https:\/\/doi.org\/10.1002\/ijc.31664.","journal-title":"International journal of cancer"},{"key":"10078_CR10","doi-asserted-by":"publisher","unstructured":"Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: a cancer journal for clinicians 2021; 71(3):209\u2013249. https:\/\/doi.org\/10.3322\/caac.21660","DOI":"10.3322\/caac.21660"},{"key":"10078_CR11","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1038\/s41591-022-01738-x","volume":"28","author":"CS Pramesh","year":"2022","unstructured":"Pramesh CS, Badwe RA, Bhoo-Pathy N, Booth CM, Chinnaswamy G, Dare AJ et al. Priorities for cancer research in low- and middle-income countries: a global perspective. Nature medicine 2022;28:649\u2013657. https:\/\/doi.org\/10.1038\/s41591-022-01738-x.","journal-title":"Nature medicine"},{"key":"10078_CR12","unstructured":"Bray F, Soerjomataram I. The Changing Global Burden of Cancer: Transitions in Human Development and Implications for Cancer Prevention and Control. In: Cancer: Disease Control Priorities, Third Edition (Volume 3). Edited by Gelband H, Jha P, Sankaranarayanan R, Horton S. Washington (DC): The International Bank for Reconstruction and Development \/ The World Bank"},{"key":"10078_CR13","unstructured":"\u00a9 2015 International Bank for Reconstruction and Development \/ The World Bank.; 2015."},{"key":"10078_CR14","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1016\/s0140-6736(20)30977-6","volume":"396","author":"Global age-sex-specific fertility","year":"2020","unstructured":"Global age-sex-specific fertility. mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950\u20132019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet (London, England) 2020;396:1160\u20131203. https:\/\/doi.org\/10.1016\/s0140-6736(20)30977-6.","journal-title":"Lancet (London, England)"},{"key":"10078_CR15","doi-asserted-by":"publisher","first-page":"2819372","DOI":"10.1155\/2017\/2819372","volume":"2017","author":"GK Singh","year":"2017","unstructured":"Singh GK, Jemal A. Socioeconomic and Racial\/Ethnic Disparities in Cancer Mortality, Incidence, and Survival in the United States, 1950\u20132014: Over Six Decades of Changing Patterns and Widening Inequalities. Journal of environmental and public health 2017;2017:2819372. https:\/\/doi.org\/10.1155\/2017\/2819372.","journal-title":"Journal of environmental and public health"},{"key":"10078_CR16","doi-asserted-by":"publisher","unstructured":"Omran AR. The epidemiologic transition: a theory of the epidemiology of population change. 1971. The Milbank quarterly 2005; 83(4):731\u2013757. https:\/\/doi.org\/10.1111\/j.1468-0009.2005.00398.x","DOI":"10.1111\/j.1468-0009.2005.00398.x"},{"key":"10078_CR17","doi-asserted-by":"publisher","unstructured":"Braveman P, Gottlieb L. The social determinants of health: it\u2019s time to consider the causes of the causes. Public health reports (Washington, DC : 1974) 2014; 129 Suppl 2(Suppl 2):19\u201331. https:\/\/doi.org\/10.1177\/00333549141291s206","DOI":"10.1177\/00333549141291s206"},{"key":"10078_CR18","doi-asserted-by":"publisher","unstructured":"Diniz da Concei\u00e7\u00e3o L, Leite da Silva LF, Macambira Noronha M, Belotto M, Cury Megid TB, D\u2019Alpino Peixoto R. Current and Future Global Burden of Early-Onset Pancreatic Cancer: A Population-Based Study. JCO global oncology 2025; 11:e2500016. https:\/\/doi.org\/10.1200\/go-25-00016","DOI":"10.1200\/go-25-00016"},{"key":"10078_CR19","doi-asserted-by":"publisher","first-page":"1588","DOI":"10.2337\/db20-0084","volume":"69","author":"S Yuan","year":"2020","unstructured":"Yuan S, Kar S, Carter P, Vithayathil M, Mason AM, Burgess S et al. Is Type 2 Diabetes Causally Associated With Cancer Risk? Evidence From a Two-Sample Mendelian Randomization Study. Diabetes 2020;69:1588\u20131596. https:\/\/doi.org\/10.2337\/db20-0084.","journal-title":"Diabetes"},{"key":"10078_CR20","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1001\/jamaoncol.2021.6987","volume":"8","author":"JM Kocarnik","year":"2022","unstructured":"Kocarnik JM, Compton K, Dean FE, Fu W, Gaw BL, Harvey JD et al. Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019. JAMA oncology 2022;8:420\u2013444. https:\/\/doi.org\/10.1001\/jamaoncol.2021.6987.","journal-title":"JAMA oncology"},{"key":"10078_CR21","doi-asserted-by":"publisher","first-page":"828","DOI":"10.18632\/oncotarget.28242","volume":"13","author":"MB Ulanja","year":"2022","unstructured":"Ulanja MB, Moody AE, Beutler BD, Antwi-Amoabeng D, Rahman GA, Alese OB. Early-onset pancreatic cancer: a review of molecular mechanisms, management, and survival. Oncotarget 2022;13:828\u2013841. https:\/\/doi.org\/10.18632\/oncotarget.28242.","journal-title":"Oncotarget"},{"key":"10078_CR22","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.4708","volume":"4","author":"L Rahib","year":"2021","unstructured":"Rahib L, Wehner MR, Matrisian LM, Nead KT. Estimated Projection of US Cancer Incidence and Death to 2040. JAMA network open 2021;4:e214708. https:\/\/doi.org\/10.1001\/jamanetworkopen.2021.4708.","journal-title":"JAMA network open"},{"key":"10078_CR23","doi-asserted-by":"publisher","unstructured":"Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990\u20132019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet (London, England) 2021; 397(10292):2337\u20132360. https:\/\/doi.org\/10.1016\/s0140-6736(21)01169-7","DOI":"10.1016\/s0140-6736(21)01169-7"},{"key":"10078_CR24","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1038\/nrendo.2017.151","volume":"14","author":"Y Zheng","year":"2018","unstructured":"Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature reviews Endocrinology 2018;14:88\u201398. https:\/\/doi.org\/10.1038\/nrendo.2017.151.","journal-title":"Nature reviews Endocrinology"},{"key":"10078_CR25","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1056\/NEJMoa1614362","volume":"377","author":"A Afshin","year":"2017","unstructured":"Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, Lee A et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. The New England journal of medicine 2017;377:13\u201327. https:\/\/doi.org\/10.1056\/NEJMoa1614362.","journal-title":"The New England journal of medicine"},{"key":"10078_CR26","doi-asserted-by":"publisher","first-page":"1168700","DOI":"10.3389\/fendo.2023.1168700","volume":"14","author":"CP Kung","year":"2023","unstructured":"Kung CP, Barnoud T, Yao CH, Murphy ME. Editorial: Double-edged swords: Important factors connecting metabolic disorders and cancer development - from basic research to translational applications. Frontiers in endocrinology 2023;14:1168700. https:\/\/doi.org\/10.3389\/fendo.2023.1168700.","journal-title":"Frontiers in endocrinology"},{"key":"10078_CR27","doi-asserted-by":"publisher","first-page":"e6","DOI":"10.1016\/s2213-8587(18)30150-5","volume":"6","author":"J Pearson-Stuttard","year":"2018","unstructured":"Pearson-Stuttard J, Zhou B, Kontis V, Bentham J, Gunter MJ, Ezzati M. Worldwide burden of cancer attributable to diabetes and high body-mass index: a comparative risk assessment. The lancet Diabetes & endocrinology 2018;6:e6\u2013e15. https:\/\/doi.org\/10.1016\/s2213-8587(18)30150-5.","journal-title":"The lancet Diabetes & endocrinology"},{"key":"10078_CR28","doi-asserted-by":"publisher","first-page":"e251","DOI":"10.1016\/s1470-2045(21)00720-8","volume":"23","author":"W Ngwa","year":"2022","unstructured":"Ngwa W, Addai BW, Adewole I, Ainsworth V, Alaro J, Alatise OI et al. Cancer in sub-Saharan Africa: a Lancet Oncology Commission. The Lancet Oncology 2022;23:e251\u2013e312. https:\/\/doi.org\/10.1016\/s1470-2045(21)00720-8.","journal-title":"The Lancet Oncology"},{"key":"10078_CR29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2024.100982","volume":"3","author":"AE Johnson","year":"2024","unstructured":"Johnson AE, Grant JK, Contreras JP, Grant AJ, Joynt Maddox K, Sengupta PP et al. Health Equity: A Call to Action for Innovators, Clinical Leaders, and Policymakers. JACC Advances 2024;3:100982. https:\/\/doi.org\/10.1016\/j.jacadv.2024.100982.","journal-title":"JACC Advances"},{"key":"10078_CR30","doi-asserted-by":"publisher","unstructured":"Fidler-Benaoudia MM, Torre LA, Bray F, Ferlay J, Jemal A. Lung cancer incidence in young women vs. young men: A systematic analysis in 40 countries. International journal of cancer 2020; 147(3):811\u2013819. https:\/\/doi.org\/10.1002\/ijc.32809","DOI":"10.1002\/ijc.32809"},{"key":"10078_CR31","doi-asserted-by":"publisher","unstructured":"Alcohol use and burden for 195 countries and territories, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet (London, England) 2018; 392(10152):1015\u20131035. https:\/\/doi.org\/10.1016\/s0140-6736(18)31310-2","DOI":"10.1016\/s0140-6736(18)31310-2"},{"key":"10078_CR32","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1016\/s1470-2045(06)70969-x","volume":"7","author":"K Straif","year":"2006","unstructured":"Straif K, Baan R, Grosse Y, Secretan B, El Ghissassi F, Cogliano V. Carcinogenicity of household solid fuel combustion and of high-temperature frying. The Lancet Oncology 2006;7:977\u2013978. https:\/\/doi.org\/10.1016\/s1470-2045(06)70969-x.","journal-title":"The Lancet Oncology"},{"key":"10078_CR33","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1186\/s12885-025-13914-6","volume":"25","author":"B Zou","year":"2025","unstructured":"Zou B, Wu P, Chen J, Luo J, Lei Y, Luo Q et al. The global burden of cancers attributable to occupational factors, 1990\u20132021. BMC cancer 2025;25:503. https:\/\/doi.org\/10.1186\/s12885-025-13914-6.","journal-title":"BMC cancer"},{"key":"10078_CR34","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1038\/s41698-025-00820-0","volume":"9","author":"Z Tan","year":"2025","unstructured":"Tan Z, Meng Y, Wu Y, Zhen J, He H, Pu Y et al. The burden and temporal trend of early onset pancreatic cancer based on the GBD 2021. NPJ precision oncology 2025;9:32. https:\/\/doi.org\/10.1038\/s41698-025-00820-0.","journal-title":"NPJ precision oncology"},{"key":"10078_CR35","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s12992-025-01124-5","volume":"21","author":"Z Xie","year":"2025","unstructured":"Xie Z, Zhong G, Xu C, Chen T, Du Z, Wei Y et al. Trends and cross-country inequalities of alcohol use disorders: findings from the global burden of disease study 2021. Globalization and health 2025;21:30. https:\/\/doi.org\/10.1186\/s12992-025-01124-5.","journal-title":"Globalization and health"},{"key":"10078_CR36","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1016\/s0140-6736(15)60171-4","volume":"386","author":"L Mikkelsen","year":"2015","unstructured":"Mikkelsen L, Phillips DE, AbouZahr C, Setel PW, de Savigny D, Lozano R et al. A global assessment of civil registration and vital statistics systems: monitoring data quality and progress. Lancet (London, England) 2015;386:1395\u20131406. https:\/\/doi.org\/10.1016\/s0140-6736(15)60171-4.","journal-title":"Lancet (London, England)"},{"key":"10078_CR37","doi-asserted-by":"publisher","unstructured":"Health effects of dietary risks in 195 countries, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet (London, England) 2019; 393(10184):1958\u20131972. https:\/\/doi.org\/10.1016\/s0140-6736(19)30041-8","DOI":"10.1016\/s0140-6736(19)30041-8"}],"container-title":["Digestive Diseases and Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10620-026-10078-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10620-026-10078-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10620-026-10078-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T02:18:11Z","timestamp":1789006691000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10620-026-10078-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,26]]},"references-count":37,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10078"],"URL":"https:\/\/doi.org\/10.1007\/s10620-026-10078-6","relation":{},"ISSN":["0163-2116","1573-2568"],"issn-type":[{"value":"0163-2116","type":"print"},{"value":"1573-2568","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,26]]},"assertion":[{"value":"12 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":4,"name":"Ethics","label":"Consent to publish","group":{"name":"EthicsHeading","label":"Declarations"}}]}}