JMIR Publications

Background:

A better understanding of the disease burden will facilitate the development of preventive measures and the planning of health care resources. There may be commonalities in screening, diagnosis, treatment, risk factors, and prevalence across digestive and respiratory tract cancers, and understanding the burden of disease by system will help provide a comprehensive picture of the overall burden of disease and provide a reference for specialists, policymakers, and specific risk populations.

Objective:

This study aimed to compare the magnitude, distribution, and their future trends of the cancer burdens of gastrointestinal (GI) and respiratory tracts.

Methods:

Data from a total of eight cancers of the digestive and respiratory tracts in the Global Burden of Disease (GBD) database were used for comparison. The age-standardized incidence rates (ASIRs), age-standardized death rate (ASDR), attributable mortality, disability-adjusted life years (DALYs), and estimated annual percentage changes (EAPCs) were analyzed. The future epidemiological trends were predicted with Bayesian age-period-cohort (BAPC) and NORDPRED models. The performances of two models were compared to optimize the forecast results.

Results:

In 2019, the disease burdens of respiratory and digestive tract cancers changed to 38568363.53 and 66912328.72 in DALY, 34.28 and 55.32 in ASIR, and 656.82 and 808.22 in ASDR per 100,000 population with changes of +54.63% and +43.93%, +2.92% and +5.65%, and -17.39% and -26.83% compared to those in 1990, respectively. The ASIR, ASDR, DALY, and their EAPC values of respiratory and digestive tract cancers are diverse across regions, countries, and territories. Notably, significant cross-regional differences in the cancer burdens of these two types were observed among regions with different social development indexes (SDIs). Compared to four representative chronic diseases, the burden of cancers showed less remission and greater global inequalities. The burdens of both digestive and respiratory tract cancers were higher in males than in females. All kinds of digestive and respiratory tract cancers are related to tobacco. Alcohol use contributes to most digestive and respiratory tract cancers, except for stomach cancer and TBL cancer. The disease burden indicators of respiratory and digestive tract cancers are likely to decrease substantially between 2020-2044. In most cases except the ASIR and male-to-female ratios of ASDR and ASDALY in digestive tract cancers, the worldwide variances of burden metrics have been decreasing in the past decades and will possibly maintain stable trends in the future years.

Conclusions:

The epidemiology of respiratory and GI tract cancers has common features and individual characteristics that are reflected in geography, age characteristics, and risk factors. Current epidemiological status, future trends, and the globalization of disease burden are important factors for making more scientific coordination and planning in terms of economic and human resources to minimize the cancer burden metrics and their cross-regional inequalities.

Clinicaltrial: