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Digestive system cancer mortality trends by age and sex in Peru, 2001-2020, and projections to 2030

Solis-Sanchez, G.; Lengua-Olivares, O. A.; Curisinche-Rojas, M.; Vidal-Anzardo, M. H.; Muro-Cieza, J. F. d. F.; Aliaga-Llerena de Nunez, K. M.

2025-12-20 epidemiology
10.64898/2025.12.17.25342534 medRxiv
Show abstract

BackgroundDigestive system cancer is a leading cause of mortality worldwide. This study aimed to identify changes in digestive system cancer mortality in Peru (2001-2020) by age and sex, and to predict trends through 2030. MethodsDeath records for digestive system cancers (anus, colon, esophagus, stomach, liver and intrahepatic bile ducts, small intestine, pancreas, rectum, biliary tract, and gallbladder) in Peru were analyzed from the World Health Organization mortality database for 2001-2020. Crude mortality rates (CMR) and age-standardized mortality rates (ASMR) per 100,000 inhabitants were calculated by sex, as well as sex ratios and the difference in ASMR between the study period endpoints. Trends were evaluated using Joinpoint regression, and projections to 2030 were performed using the Age-Period-Cohort model with the Nordpred package in R. ResultsOn average during the period, a digestive system cancer CMR and ASMR of 23.47 and 27.32, respectively, were identified; stomach cancer presented the highest mortality in the study period. During this time, colon cancer surpassed liver cancer as the second leading cause of mortality, with a 65.0% increase in ASMR, representing the largest increase variation between 2001-2020. Conversely, esophageal cancer showed the greatest reduction, with a 25.8% decrease. Regarding projections, we found that between 2021 and 2025, compared to 2020, an increase in ASMR would occur in both sexes only for biliary tract cancer; and this increase is projected to affect six of the ten cancer types during the 2026-2030 period for both sexes. ConclusionMortality patterns were heterogeneous, with marked increases observed from 2016 to 2020. Projections suggest a subtle reduction in the 2021-2025 period followed by a resurgence between 2026 and 2030, particularly for colon, stomach, small intestine, pancreas, rectum, and biliary tract cancers. Strengthening prevention and early detection strategies is crucial.

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