Early-onset digestive system cancers attributable to the GBD composite dietary risk in China, 1990–2023: burden, trends, and projections

BackgroundDigestive system cancers attributable to the aggregate dietary risk category defined by the Global Burden of Disease (GBD) study represent an important public health concern among Chinese adults aged 25–49 years. This study evaluated their burden, temporal trends, age-period-cohort patterns, and model-based projections.MethodsData on deaths and disability-adjusted life years (DALYs) attributable to the GBD aggregate dietary risk category were obtained for Chinese individuals aged 25–49 years from 1990 to 2023. Joinpoint regression was used to analyze temporal trends, an age-period-cohort (APC) model was used to estimate age, period, and cohort effects, and a Bayesian age-period-cohort (BAPC) model was used to project the burden through 2050.ResultsIn 2023, these cancers were associated with 7,134 deaths and 349,764 DALYs. The burden among males was more than twice that among females. Age-standardized mortality and DALY rates declined significantly from 1990 to 2023 across all analyzed age and sex groups. The APC analysis showed lower relative risks in more recent periods and younger birth cohorts. The BAPC model projected substantial increases in the absolute numbers of deaths and DALYs by 2050, accompanied by increases in the corresponding age-standardized rates.ConclusionAlthough age-standardized mortality and DALY rates declined from 1990 to 2023, the BAPC model projected increases in both the absolute burden and age-standardized rates of digestive system cancers attributable to the aggregate dietary risk category through 2050. These findings represent conditional model-based projections and support continued attention to sex-specific dietary-risk prevention and control strategies.