Yu-Qing Gong

Gastrointestinal cancers account for 39.0% of global cancer-related deaths. The rising incidence of early-onset gastrointestinal cancers poses a substantial public health challenge due to their aggressive nature and poor prognosis. Using the Global Burden of Disease (GBD) 2021 database, we analyzed temporal trends (1990-2021) in age-standardized incidence (ASIR), mortality (ASMR), and disability-adjusted life years (ASDR) rates for early-onset gastrointestinal cancers among individuals aged 15-49 years. Analyses included burden by age, sex, region, and socio-demographic index (SDI). Joinpoint regression estimated average annual percentage changes (AAPC), and future trends (2022-2036) were projected using the Bayesian Age-Period-Cohort model. In 2021, there were 499,800 new cases of early-onset gastrointestinal cancers globally. Colorectal and stomach cancers were most prevalent. From 1990-2021, ASIR increased only for colorectal cancer (AAPC: 0.37, 95%CI: 0.24-0.50), while declines occurred in esophageal, stomach, liver, pancreatic, and gallbladder/biliary tract cancers. Males bore a higher burden except for gallbladder/biliary tract cancer. Significant disparities existed across regions, genders, and SDI levels. Smoking and high body-mass index were leading risk factors. Projections indicate rising ASIRs for early-onset colorectal and esophageal cancers, stable liver cancer incidence, and diminishing incidence, mortality, and DALYs rates for stomach, pancreatic, and gallbladder and biliary tract cancers. Early-onset gastrointestinal cancers represent a substantial and evolving global burden, with notable variations by cancer type, age, sex, region, and SDI. Targeted prevention and healthcare strategies are urgently needed to address modifiable risk factors and reduce disparities.

IgA vasculitis (IgAV), previously known as Henoch-Schönlein purpura, is an IgA-mediated systemic small vessel vasculitis that tends to be more severe in adults than in children. Early diagnosis of IgAV involving the gastrointestinal tract remains difficult, especially in patients who present with gastrointestinal symptoms before purpura. This study aims to systematically analyze the abdominal imaging and endoscopic features of adult patients with abdominal IgAV, providing assistance to clinicians in the early recognition of this condition. This multicenter retrospective study was conducted in three large tertiary hospitals in China from January 2017 to January 2024. A total of 108 adult patients with abdominal IgAV, who had complete abdominal imaging and/or endoscopy results, were enrolled. The clinical manifestations, abdominal imaging findings, endoscopic characteristics, and serological indicators of the patients were analyzed. The median age of the patients was 40 years (IQR: 26-55), with a male-to-female ratio of 2:1. Acute abdominal pain was the most common presenting symptom (100 patients, 92.59%). Bowel wall thickening was the most frequent finding on abdominal imaging (50/86 patients, 58.14%). Gastrointestinal endoscopy showed findings of congestion and erosion (32/67 patients, 47.76%), and erosion with ulcers (21/67 patients, 31.34%). Among patients with both imaging and endoscopic results, the duodenum (28/51 patients, 54.90%) and ileum (28/51 patients, 54.90%) were the most commonly affected sites. Laboratory findings revealed elevated white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), D-dimer and fibrinogen levels, along with decreased albumin level. Comparing patients with gastrointestinal symptoms versus purpura as the initial symptom, those with gastrointestinal symptoms had higher levels of WBC (p < 0.05) and NLR (p < 0.01). The most common symptom in adult abdominal IgAV patients is acute abdominal pain. In the early stage of the disease, most patients exhibit elevated levels of WBC, NLR, CRP, D-dimer, and fibrinogen, along with decreased albumin level. The duodenum and ileum are the most commonly affected sites. By integrating these findings, clinicians can identify abdominal IgAV patients earlier and more accurately.

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An abstract is unavailable. This article is available as a PDF only.