Global Burden of Early-Onset Gastrointestinal Cancers Among Core Labor Force From 1990 to 2021: Insights From the Global Burden of Disease Study 2021

IntroductionThe global status of core labor force (CLF) health is underestimated, particularly the burden of patients with early-onset gastrointestinal cancers (EOGICs), aged 15-49 years old. We aim to investigate the pattern and trend of EOGICs among CLF from 1990 to 2021.MethodsEOGIC burden and its attributable risk factors were estimated using data from the GBD 2021. The ASR and EAPC by age, sex and SDI were utilized for measuring incidence rate trends. Joinpoint regression analysis was utilized to explore the variation in disease burden. The Bayesian Age-Period-Cohort (BAPC) model was performed to forecast the disease burden up to 2050.ResultsFrom 1990 to 2021, the global ASIR for EOGICs among core labor force remained broadly stable, moving from 10.9 to 9.62 per 100,000(EAPC=-0.42, -1.70 to 0.87), while incident cases increased from 295,514 to 379,709. The overall incidence pattern was driven largely by declines in early-onset GC. The age-standardized DALY rate declined from 375.16 to 238.40 per 100,000(EAPC=-1.46, -2.76 to -0.15). Only early-onset CRC showed increasing DALYs. Joinpoint analysis showed a continuous downward trend in the ASIR for overall EOGICs(AAPC=-0.97%; -0.81 to -1.08). Risk-factor decomposition indicated substantial contributions from modifiable exposures, mainly led by smoking, alcohol use, and dietary risks, with marked sex- and age-specific variation.ConclusionThe results of the present study are significant for global health policy and practice in core labor force. Differentiated intervention and outreach strategies based on age and gender would be necessary to reduce the impact of EOGICs.