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Año 2025 / Volumen 117 / Número 10
Original

Trends in early- and late-onset gastrointestinal cancer mortality in Spain, 1999-2023

564-571

DOI: 10.17235/reed.2025.11389/2025

Lucía Cayuela, Victoria Achaval, Gema Flox-Benítez, Aurelio Cayuela Domínguez,

Resumen

Background: this study analyses mortality trends in early-onset gastrointestinal cancers (EOGIC, < 50 years) in Spain between 1999 and 2023, comparing them with those of late-onset cancers (≥ 50 years). Methods: data from the Spanish National Institute of Statistics were used to calculate age-standardized mortality rates. Joinpoint regression was applied to identify trend changes, reporting average annual percentage change (AAPC) and annual percentage change (APC), with 95 % confidence intervals. Results: EOGIC mortality declined across most cancer sites and in both sexes. Among men, the largest decreases were observed in esophageal (-5.6 %) and stomach cancers (-4.0 %), followed by liver (-3.7 %) and colon (-3.2 %). In women, esophageal cancer showed the greatest reduction (-4.3 %), followed by colon (-2.6 %), stomach (-2.2 %), rectal and liver cancers. Pancreatic cancer mortality remained stable in younger women but began to decline from 2007 onwards (-1.2 %). In adults aged 50 and over, trends were more variable: pancreatic cancer mortality increased (men: +1.0 %; women: +1.6 %), while stomach cancer mortality declined (men: -3.3 %; women: -2.9 %). Colon cancer showed steeper declines from 2011-2012. Liver, rectal and other digestive cancers showed modest decreases. Esophageal cancer mortality declined in men but remained stable in women. Conclusion: EOGIC mortality in Spain declined steadily over the study period, whereas trends in late-onset cancers were more irregular. These findings highlight the need for age-specific cancer prevention and control strategies.

Resumen coloquial

Digestive system cancers—such as those affecting the stomach, colon, liver, and pancreas—are a significant global health concern. While these cancers typically occur in older adults, cases in people under 50 (early-onset) have been climbing. This study looked at how both death rates and absolute numbers of deaths changed in Spain from 1999 to 2023 for younger (under 50) and older (50 and over) adults. For those under 50, death rates for most digestive cancers—esophageal, stomach, liver, and colon—fell steadily, indicating that prevention, earlier diagnosis, and better treatments are working. However, although the rate of pancreatic cancer deaths in young women stayed roughly flat initially, the number of deaths actually rose, highlighting a growing burden in real terms. After 2007, the pancreatic cancer rate began to decline, helping to curb these numbers. Among adults aged 50 and over, trends were mixed. The rates of stomach and colon cancer deaths dropped significantly—especially after 2011. In contrast, the rates of pancreatic cancer deaths climbed by about 1 % per year in men and 1.6 % in women, which translated into more people dying from pancreatic cancer. Death rates for liver, rectal, and other digestive cancers dipped slightly, while esophageal cancer rates fell in men but remained steady in women. Overall, Spain has made real progress in lowering early-onset digestive cancer death rates, but the rising numbers of pancreatic cancer deaths—particularly among older adults and young women—show why age-specific prevention and care remain crucial.

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Recibido: 03/06/2025

Aceptado: 09/06/2025

Prepublicado: 27/06/2025

Publicado: 10/10/2025

Tiempo de prepublicación: 24 días

Tiempo de edición del artículo: 129 días

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