Aug 2026· PLoS ONE· Vol 21· 0 citations· 30 references
Medicine
TL;DR
The global EOPC burden among WCBA and its links to core metabolic determinants are delineated, providing an evidence base to guide targeted interventions in this priority population and support progress toward international development goals.
Abstract
Introduction Early-onset pancreatic cancer (EOPC), diagnosed before age 50, is rising globally. Women of childbearing age (WCBA, 15–49 years) constitute nearly the same population as EOPC patients but have unique metabolic vulnerabilities. The intersection of EOPC trends with WCBA-specific metabolic risks remains underexplored. This study delineates the global EOPC burden among WCBA and its links to core metabolic determinants, providing an evidence base to guide targeted interventions in this priority population and support progress toward international development goals. Methods A two-stage design was employed. First, Global Burden of Disease 2023 data were analyzed to assess EOPC mortality and disability-adjusted life years (DALYs) among WCBA (1990–2023), quantifying trends and population attributable fractions (PAFs) for high fasting blood glucose (FBG) and high body mass index (BMI). Second, a retrospective case-control study provided supportive clinical correlation for the identified risk factors. Results Globally, absolute EOPC deaths and DALYs in WCBA more than doubled from 1990 to 2023. Age-standardized rates remained stable globally, but increased in low and middle Sociodemographic Index (SDI) regions. High FBG was the largest population-attributable risk factor (global PAF = approximately 64%), with an inverse SDI gradient. High BMI PAF showed an inverted U-shaped distribution. In the supportive clinical analysis, high FBG remained independently associated with EOPC (adjusted OR=4.64; 95% CI: 2.88–7.49), while high BMI lost significance after adjustment, suggesting overlapping metabolic pathways. Conclusion Demographic factors (population growth and aging) drive most of the increase in absolute EOPC burden among WCBA. High FBG is the leading modifiable risk factor at the population level, though reverse causation may partly explain its strong association. Targeted glycemic control and metabolic interventions are urgently needed in this population.
Gastric cancer (GC) in adolescents and young adults (AYA; 15–39 years) is rare but clinically distinct. Contemporary global estimates and temporal drivers – particularly age–period–cohort (APC) effects and socioeconomic differentials – remain unclear. We conducted a secondary analysis using data from the Global Burden of Disease 2021 database and quantified the incidence, mortality, and disability-adjusted life years of AYA GC across 204 countries and territories from 1990 to 2021. Age-standardized rates and estimated annual percentage changes (EAPCs) were calculated using log-linear regression. APC models were used to describe age-, period-, and cohort-related patterns. Disease burden was stratified by Socio-demographic Index (SDI), and Global Burden of Disease (GBD)-attributed deaths related to diets high in sodium and smoking were examined within the GBD comparative risk assessment framework. From 1990 to 2021, the global AYA GC burden declined substantially, yet disparities by sex, SDI, and cohort persisted. Globally, the age-standardized incidence rate of AYA GC decreased from 2.45 per 1,00,000 population in 1990 to 1.41 per 1,00,000 population in 2021, with an EAPC of −2.04% (95% confidence interval [CI]: −2.21 to −1.88). Deaths declined from 38.15 × 103 to 24.27 × 103, with an EAPC of −2.75% (95% CI: −2.94 to −2.57). The age-standardized disability-adjusted life year rate decreased from 99.73 to 46.64 per 1,00,000 population, with an EAPC of −2.54% (95% CI: −2.63 to −2.46). Males consistently had higher burdens than females. Incidence was positively correlated with SDI over time (r = 0.2393, P < .001), whereas mortality was negatively correlated with SDI in the 2021 cross-sectional analysis (r = −0.3092, P < .001). APC analysis showed a positive age effect peaking at 35 to 39 years and a net drift of −2.18% per year. Within the GBD comparative risk assessment framework, the GBD-attributed proportion of AYA GC deaths related to diets high in sodium was approximately 15% in East Asia in 2021, while the GBD-attributed proportion related to smoking exceeded 10% in parts of Central and Eastern Europe.
Mao-Qiang Liu, Zhen-Zhen Peng, Wei Liu et al.· Medicine· 0 citations
Current evidence on early-onset colorectal cancer epidemiology, biology, clinical presentation, screening, and treatment is summarized, and emerging directions including liquid biopsy, artificial intelligence, and microbiome-based strategies are highlighted.
Ahmed Sohaib, Ashwaq Salami, Wesal Alghwyeen et al.· Integrated Oncology Diagnost...· 0 citations
Traditional environmental risk factors and established common genetic variants are not associated with the rising incidence of early-onset colorectal cancer, and drivers of early-onset disease might include novel environmental exposures or early-life factors beyond traditional risk assessment.
Anmol Nigam, Chidiebere Onongaya, Pravin Meshram et al.· Diseases of the Colon & Rect...· 0 citations
Pancreatic cancer (PC) remains a major global health burden characterized by high mortality and substantial socioeconomic inequality. This study compared long-term trends, inequality patterns, and risk-factor transitions of PC burden in China and the United States from 1990 to 2023.
Using Global Burden of Disease Study (GBD) 1990–2023 data, we analyzed incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of PC. Temporal trends were assessed using Joinpoint regression analysis, calculating annual percent changes (APCs) and average annual percent changes (AAPCs). Socioeconomic inequalities were evaluated using the slope index of inequality (SII) and concentration index (CIX). Population attributable fractions (PAFs) were used to quantify major risk factors.
In 2023, China had more cases than the United States (103,000
vs.
66,000) but lower age-standardized prevalence (4.51
vs.
11.19), incidence (5.13
vs.
10.53), mortality (4.97
vs.
9.56) and DALYs per 100,000. From 1990 to 2023, burden increased in both countries, although age-standardized DALYs declined slightly in China (AAPC −0.15%) and increased in the United States (0.12%). Burden peaked at 60–74 years in China and shifted to older ages in the United States. Sex differences diminished with age and became non-significant in the oldest age groups. Globally, the burden remained concentrated in high socio-demographic index (SDI) with widening inequality. High fasting plasma glucose surpassed tobacco use as the leading attributable risk factor in the United States and became a major contributor in China.
China had a higher absolute burden but lower age-standardized rates (ASR) than the United States. The United States burden was more concentrated in older age groups, while the global burden remained concentrated in high-SDI regions with widening inequality. Rising high fasting plasma glucose underscores the need for metabolic risk management in PC prevention.
Miao Li, Bing-Qing Wu, Bo Ma et al.· Journal of Pancreatology· 0 citations
Background The incidence of early-onset colorectal cancer (EOCRC), defined as diagnosis before age 50, is rising despite declining overall colorectal cancer (CRC) rates. EOCRC presents distinct clinical challenges, with emerging associations to obesity and sociodemographic disparities. This study compares hospitalization trends, inpatient outcomes, and sociodemographics in EOCRC vs. late-onset CRC (LOCRC). Methods Using the National Inpatient Sample (NIS) (2016–2020), we identified hospitalizations with a primary diagnosis of CRC. Patients were categorized from a hospital-based classification of EOCRC (<50 years) or LOCRC (≥50 years). Multivariate logistic regression assessed associations between body mass index (BMI), demographics, and outcomes including inpatient mortality, length of stay (LOS), and chemotherapy use. Results Among 246,231 CRC hospitalizations, 13.7% (n=33,662) were EOCRC. Compared to LOCRC, EOCRC patients were more likely to be female [odds ratio (OR): 1.09], Black (OR: 1.17), Hispanic (OR: 1.56), or Asian (OR: 1.29), and more often covered by Medicaid, private insurance, or have no coverage. EOCRC patients had higher rates of tobacco use disorder (OR: 1.26) and depression (OR: 1.13), but lower prevalence of diabetes, coronary artery disease (CAD), and alcohol use disorder. EOCRC hospitalizations had lower inpatient mortality (OR: 0.649). Inpatient chemotherapy was more common in EOCRC (OR: 1.78). Obesity was positively associated with EOCRC for BMI 30–39 (OR: 1.07) and BMI ≥40 (OR: 1.50), while LOCRC showed inverse associations for the same BMI groups. Conclusions EOCRC is associated with unique demographic and clinical profiles when compared to LOCRC, highlighting disparities by race, insurance status, and comorbidities. The higher rate of inpatient chemotherapy use in EOCRC warrants further study to evaluate its clinical necessity and outcomes. These findings reinforce the need for targeted screening and inpatient care strategies for younger and underserved patient populations.
Manali Shah, Ravi Upadhyay, Lawanya Singh et al.· Journal of Gastrointestinal...· 0 citations
An elevated risk of early-onset rectal cancer was suggested in individuals with high birth weight in a nested case-control study that evaluated the association between high birth weight and eoCRC in a nested case-control study.
Amrita Mukherjee, Lan-Fang Xu, D. Getahun et al.· Cancer Epidemiology, Biomark...· 0 citations
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