National and regional lifetime risks of developing and dying from digestive system cancers in China: Findings of the Global Burden of Disease Study 2023

Abstract Background: Digestive system cancers are a leading cause of death in China, with a growing projected burden. Yet, data on the lifetime risk (LTR) of these cancers remain limited. We aimed to estimate the LTR of digestive system cancers in China at national and regional levels for 2023. Methods: For this population-based systematic analysis, we obtained estimates of incidence and mortality of digestive system cancers from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, alongside population data from the World Population Prospects, China Statistical Yearbook. The LTR of digestive system cancers was estimated with a standard method that adjusts for multiple primaries, taking into account competing risks of death from causes other than cancer and life expectancy. Results: The LTR (95% uncertainty interval [UI]) of developing and dying from digestive system cancers in China in 2023 was 11.36% (10.90–12.01%) and 8.28% (7.76–8.87%), respectively. Males exhibited higher risks for both incidence (10.82% vs. 6.85% in females) and mortality (7.58% vs. 4.95% in females). The remaining LTR of digestive system cancers decreased with advancing age. Colorectal cancer showed the highest lifetime incidence risk (3.98%), while stomach cancer had the highest lifetime mortality risk (2.69%). Gallbladder cancer consistently demonstrated the lowest risks, with a lifetime incidence of 0.32% and mortality of 0.25%. Geographic disparities were evident, with the highest LTR observed in Eastern and Northeastern regions. Northwestern region had the lowest LTR. Conclusions: In China, approximately one in 9 people will develop and one in 12 will die from digestive system cancers during their lifetime. Significant regional variations highlight the need for precision prevention and tailored health planning.