Mortality of gastrointestinal cancers attributable to smoking, alcohol, and metabolic risk factors, and its association with socioeconomic development status 2000-2021: GI Cancer Mortality and Risk Factors

Pojsakorn Danpanichkul; Kanokphong Suparan; Yanfang Pang; Thanida Auttapracha; Ethan Kai Jun Tham; Chawinthorn Vuthithammee; Karan Srisurapanont; Ekdanai Uawithya; Rinrada Worapongpaiboon; Tanawat Attachaipanich; Ryan Yan Zhe Lim; Mazen Noureddin; Amit G Singal; Suthat Liangpunsakul; Michael B Wallace; Ju Dong Yang; Karn Wijarnpreecha

doi:10.1016/j.amjmed.2024.12.019

Mortality of gastrointestinal cancers attributable to smoking, alcohol, and metabolic risk factors, and its association with socioeconomic development status 2000-2021: GI Cancer Mortality and Risk Factors

Am J Med. 2025 Jan 6:S0002-9343(24)00850-7. doi: 10.1016/j.amjmed.2024.12.019. Online ahead of print.

Authors

Pojsakorn Danpanichkul¹, Kanokphong Suparan², Yanfang Pang³, Thanida Auttapracha⁴, Ethan Kai Jun Tham⁵, Chawinthorn Vuthithammee⁶, Karan Srisurapanont⁷, Ekdanai Uawithya⁸, Rinrada Worapongpaiboon⁹, Tanawat Attachaipanich¹⁰, Ryan Yan Zhe Lim¹¹, Mazen Noureddin¹², Amit G Singal¹³, Suthat Liangpunsakul¹⁴, Michael B Wallace¹⁵, Ju Dong Yang¹⁶, Karn Wijarnpreecha¹⁷

Affiliations

¹ Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA. Electronic address: [email protected].
² Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. Electronic address: [email protected].
³ Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China; National Immunological Laboratory of Traditional Chinese Medicine, Guangxi, China; Key Laboratory of Research on Clinical Molecular Diagnosis for High Incidence Diseases in Western Guangxi, Guangxi, China; Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. Electronic address: [email protected].
⁴ Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. Electronic address: [email protected].
⁵ Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: [email protected].
⁶ Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Electronic address: [email protected].
⁷ Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai. Electronic address: [email protected].
⁸ Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. Electronic address: [email protected].
⁹ Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Electronic address: [email protected].
¹⁰ Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA. Electronic address: [email protected].
¹¹ Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: [email protected].
¹² Houston Research Institute and Houston Methodist Hospital, Houston, Texas, USA. Electronic address: [email protected].
¹³ Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA. Electronic address: [email protected].
¹⁴ Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA; Roudebush Veterans' Administration Medical Center, Indianapolis, Indiana, USA. Electronic address: [email protected].
¹⁵ Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA. Electronic address: [email protected].
¹⁶ Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, and Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA. Electronic address: [email protected].
¹⁷ Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, Arizona, USA; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Banner University Medical Center, Phoenix, Arizona, USA; BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA. Electronic address: [email protected].

PMID: 39778787
DOI: 10.1016/j.amjmed.2024.12.019

Abstract

Objective: Gastrointestinal (GI) cancers account for one-third of global cancer mortality, with nearly half being preventable. This study updates the global burden of GI cancers attributed to major risk factors: smoking, alcohol, and metabolic disturbances.

Methods: We utilized data from the Global Burden of Disease Study 2021 to examine trends in death and age-standardized death rates related to GI cancers caused by smoking, alcohol, high body mass index (BMI), and high fasting blood glucose (FBG) from 2000 to 2021. Trends were analyzed based on countries' developmental status using a sociodemographic index (SDI).

Results: In 2021, there were 1.12 million GI cancer deaths related to smoking, alcohol, high BMI, and high FBG, which was 53.6% higher than in 2000. The largest proportion of GI cancer mortality was attributed to smoking (43.3%), followed by alcohol (20.6%), high FBG (20.5%), and high BMI (15.6%). The increases in GI cancer deaths between 2000 and 2021 were related to high BMI (+102.54%) and FBG (+107.69%), particularly in liver and pancreatic cancer. In 2021, GI cancer mortality in low, low-middle, and middle SDI countries represented 44.3% of the global GI cancer mortality attributed to smoking, 41.9% for alcohol, 34.3% for high BMI, and 31.6% for high FBG. Since 2000, these proportions have increased by +4.5% for smoking, +7.6% for alcohol, +12.3% for high BMI, and +6.4% for high FBG.

Conclusion: From 2000 to 2021, GI cancer mortality increased substantially, driven primarily by obesity and alcohol. Lower SDI countries are increasingly contributing to the global GI cancer mortality burden. Immediate interventions are necessary to mitigate this growing burden.

Keywords: Cancer; Epidemiology; Gastroenterology; Obesity; Oncology; Public health.