{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T21:12:26Z","timestamp":1788469946857,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["8217100675"],"award-info":[{"award-number":["8217100675"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>The researches on the global burden of digestive system malignancy in young populations were limited. This study aimed to comprehensively investigate the burden of early\u2010onset digestive system malignancy (often defined as cancers diagnosed below the age of 50) based on the Global Burden of Disease 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data of incidence, prevalence, deaths, disability\u2010adjusted life years (DALYs), and risk factors for the five major early\u2010onset digestive system malignancies, including early\u2010onset esophageal cancer (EOEC), early\u2010onset gastric cancer (EOGC), early\u2010onset liver cancer (EOLC), early\u2010onset pancreatic cancer (EOPC), and early\u2010onset colorectal cancer (EOCRC), were extracted from GBD 2021. The average annual percent change (AAPC) was calculated using joinpoint regression analysis. The Bayesian age\u2013period\u2013cohort (BAPC) model was utilized to predict the burden up to 2030.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 1990 to 2021, the age\u2010standardized incidence rate (ASIR) of early\u2010onset digestive system malignancies, except for EOCRC (AAPC, 0.37), showed a decreasing pattern. Meanwhile, the age\u2010standardized mortality rate (ASMR) and age\u2010standardized DALYs rate (ASDR) of early\u2010onset digestive system malignancy presented a downward trend. Notably, high\u2010middle sociodemographic index (SDI) countries experienced higher disease burdens. Dietary risk factors, tobacco, alcohol consumption, and metabolic factors were the main risk factors. The ASIR of EOEC and EOCRC was projected to increase in 2030, whereas the trend for EOGC, EOLC, and EOPC was projected to decrease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Early\u2010onset digestive system malignancy presented notable heterogeneity across gender, geography, and cancer types. This emphasizes the urgency of addressing the public health challenge of early\u2010onset digestive system malignancy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.17012","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T09:35:25Z","timestamp":1747906525000},"page":"1525-1535","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Global Epidemiology of Early\u2010Onset Digestive System Malignancy: A Systematic Analysis for the Global Burden of Disease Study 2021"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7616-9365","authenticated-orcid":false,"given":"Jiayi","family":"Wang","sequence":"first","affiliation":[{"name":"Endoscopy Center Minhang District Central Hospital of Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deming","family":"Li","sequence":"additional","affiliation":[{"name":"Endoscopy 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