Screening for GI cancer and payment mechanisms

Background: Previous studies have extensively explored the correlation between preoperative skeletal muscle mass and long-term survival in gastrointestinal cancers. However, investigations into postoperative skeletal muscle mass alterations are limited. In gastrointestinal cancers, factors such as the tumor and surgical interventions can significantly impact dietary intake, nutritional status, and skeletal muscle mass, affecting postoperative body composition. This study aimed to examine these postoperative changes in skeletal muscle mass across different gastrointestinal cancers, including esophageal, gastric, and colorectum. Methods: This study encompassed 969 patients with Stage I-III esophageal (307 cases), gastric (278 cases), and colorectal (384 cases) cancers who underwent radical resection between 2005 and 2019. Skeletal muscle mass was quantified as the total psoas volume (TPV), measured using Ziostation2® imaging software from preoperative and postoperative CT scans at 1, 2, and 3 years. The study compared postoperative TPV trends across the different cancer types. Results: The study cohort comprised patients with esophageal (median age 66 years, 85% male), gastric (65 years, 60%), and colorectal cancers (67 years, 55%). Median BMIs were 21.5, 19.4, and 22.6 kg/m2, and median TPVs were 352.0, 305.8, and 309.5 cm3 for esophageal, gastric, and colorectal cancers, respectively. Esophageal cancer patients had significantly higher TPV and male predominance, while gastric cancer patients had notably lower BMI. Relative to preoperative TPV, the postoperative TPV at three years was 0.92, 0.91, and 0.96 for esophageal, gastric, and colorectal cancers, respectively. A year-by-year decrease in TPV was observed for each cancer type, with colorectal cancer demonstrating a less pronounced decrease compared to esophageal and gastric cancers (p<0.01). Stage-wise analysis revealed no significant differences among the cancer types. Regarding gender, no significant differences were noted between gastric and colorectal cancers, but esophageal cancer showed a more marked decrease in TPV in males compared to females. In recurrent cases, no significant TPV differences were observed in esophageal cancer, while recurrent gastric and colorectal cancers exhibited significant TPV decreases. Conclusions: The study indicates a general decline in TPV following gastrointestinal cancer surgery, with the extent of reduction varying according to the type of tumor and treatment. Citation Format: Yuto Maeda, Yuji Miyamoto, Mayuko Ohuchi, Yukiharu Hiyoshi, Naoya Yoshida, Hideo Baba. Changes in skeletal muscle mass after gastrointestinal cancer surgery by body composition [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2401.

The methyltransferase gene family is known for its diverse biological functions and critical role in tumorigenesis. This study aimed to identify these family genes in common gastrointestinal (GI) cancers using comprehensive methodologies. Gene identification involved analysis of scientific literature and insights from The Cancer Genome Atlas (TCGA) database. RNA sequencing (RNA-seq) data for colon, gastric, pancreatic, esophageal, and liver cancers were collected, processed, and normalized. Differential expression analysis was conducted using R software with the Limma package. Additionally, real-time PCR analysis was performed on 30 tumor and 30 normal tissue samples from patients with colon and gastric cancer. Pathway analysis was conducted via the EnrichR web tool, while survival analysis used Cox regression methods, and biomarker potential was assessed with the pROC package. Prognostic significance was evaluated by examining associations between gene expression, patient survival, and recurrence rates. The study also investigated diagnostic potential through receiver operating characteristic (ROC) analysis, and assessed how small molecules affect gene expression, with implications for drug resistance and sensitivity, analyzed via CCLE and GDSC datasets. Findings revealed METTL5 overexpression in colon, liver, esophagus, and pancreas cancers, while METTL7A was underexpressed in gastric, esophagus, liver, and colon cancers. METTL7B expression varied, being higher in gastric and esophagus cancers but lower in liver and colon cancers. Enrichment analysis identified pathways related to these genes, and survival analysis associated altered METTL7A and METTL5 expressions with poor prognosis and higher recurrence rates. These findings suggest that METTL genes could serve as predictive biomarkers in GI cancers, offering potential implications for patient prognosis and treatment response.

Background: Cancer is a low priority health concern in Nigeria. Epidemiological and histopathological profile of primary gastrointestinal tract cancer (PGITC) is poorly characterized in this region. Aims: This paper addresses the trend, age, gender, and histological profile of PGITC in Delta State, Nigeria. Materials and Method: The study is a 75-month (2014-2020) descriptive, retrospective analysis of gastrointestinal (esophagus, stomach, intestinal and anal) cancers in Delta State University Teaching Hospital, Nigeria. Duplicate copies of histopathology reports of PGITC were examined for age, sex, site and histological diagnosis, and the results analyzed using Excel spreadsheet version 2016. Results: PGITC accounts for 15.6% of all cancers. Equal gender distribution was observed. The age range and mean age of affected patients were 23-90 years and 53.4 ±14.16 years respectively. The yearly trend undulated with two peaks in 2015 and 2019. The 3rd, 4th, 5th, 6th, 7th, 8th, 9th and 10th decades accounted for 5 (4.6%), 13 (12.0%), 21 (19.4%), 32 (29.6%), 24 (22.2%), 9 (8.3%), 3 (2.8%) and 1 (0.9%) of cases respectively. Esophageal, stomach, small intestinal, colorectal and anal cancers accounted for 6 (5.6%), 13 (12.0%), 5 (4.6%), 82 (75.9%), and 2 (1.9%) of the cases. Most colorectal and stomach cancers were adenocarcinomas. Squamous cell cancers are the most common esophageal and anal cancers while sarcomas were mostly from the small intestine. Conclusion: PGITC are relatively common in this study and mostly carcinoma with mean age and peak in the 6th decade. Colorectal cancers are distinctly the most common. There is a need for routine imaging screening to prevent gastrointestinal cancer in this region.

A Functional Polymorphism of Toll-Like Receptor 4 Gene Increases Risk of Gastric Carcinoma and Its Precursors

735 Background: Molecular characteristics hold substantial clinical significance in cancer. Previous research has elucidated the molecular classification of gastrointestinal (GI) cancers, leveraging biomarkers like gene alterations, MSI, EBV status, and chromosomal instability. However, most of these studies relied on tissue biopsies. Limited investigations have been documented regarding the characterization of molecular profiles through liquid biopsy. Here we present a comprehensive genomic profiling study conducted on advanced GI cancer patients using blood samples. Methods: This prospective study is a part of a global initiative focused on molecular biomarker screening across various solid tumors. Here we report the early result of 106 unresectable GI cancer patients, encompassing those with advanced disease or experiencing relapse after prior treatments. The cohort comprises 66 colorectal cancer (CRC) patients, 34 gastric cancer (GC) patients, and 6 esophageal cancer (EC) patients. Each patient contributed a 10-mL blood sample for comprehensive circulating tumor DNA (ctDNA) analysis. The study employed PredicineCARE, a 152-gene, NGS-based liquid biopsy assay, to profile somatic gene variations within this patient population. Results: The study revealed a total of 1,597 somatic mutations, with 1,077 occurring in CRC, 448 in GC, and 72 in EC. Additionally, 722 gene copy number variants were identified, with 288 in CRC, 351 in GC, and 83 in EC patients. In CRC, the most frequently altered genes (prevalence > 20%) included TP53 (58%), APC (45%), KRAS (33%), and BRCA2 (22%). Conversely, in GC, the most altered genes were TP53 (59%), TERT (35%), FAT1 (29%), ARID1A (26%), and FGFR4 (24%). Among the 6 EC patients, 3 carried TP53 variations, with variations in APC (N=2), ERCC5 (N=2), FAT1 (N=2), and EGFR (N=1) also observed. The mutation burden in CRC (median 3.73 mut/Mb) and GC (median 3.57 mut/Mb) displayed no significant differences. However, the mutation burden in CRC was significantly higher than that in EC (2.24 mut/Mb) (p=0.04). A similar pattern was observed between GC and EC but did not reach statistical significance (p=0.10) due to limitations in cohort size. Furthermore, the assay identified patients carrying both germline and somatic mutations related to homologous recombination deficiency (HRD). In CRC patients, 5 had MLH1 germline mutations, 6 had MSH2 mutations (5 were germline), 4 had MSH6 germline mutations, 2 had PMS2 somatic mutations, and 1 had an EPCAM germline mutation. While in GC patients, 2 had MLH1 germline mutations, 1 had an MSH6 mutation, and 1 had a PMS2 somatic mutation. Conclusions: This study elucidated the comprehensive mutational landscape of advanced gastrointestinal cancer through liquid biopsy, thereby contributing novel biomarkers for clinical diagnosis and facilitating targeted therapy mechanism investigations.

Gastrointestinal cancers (GICs) are a huge threat to human health, which mainly include esophageal, gastric, and colorectal cancers. The purpose of this study was to clarify the prognostic value of long noncoding RNAs (lncRNAs) in GICs. A total of 111 articles were included, and 13103 patients (3123 with esophageal cancer, 4972 with gastric cancer, and 5008 with colorectal cancer) were enrolled in this study. The pooled hazard ratio (HR) values and corresponding 95% confidence interval (95% CI) of overall survival (OS) related to different lncRNA expressions in esophageal, gastric, colorectal, and gastrointestinal cancer patients were 1.92 (1.70–2.16), 1.96 (1.77–2.16), 2.10 (1.87–2.36), and 2.00 (1.87–2.13), respectively. We have identified 74 lncRNAs which were associated closely with poor prognosis of GIC patients, including 58 significantly upregulated lncRNA expression and 16 significantly downregulated lncRNA expression. In addition, 47 of the included studies revealed relative mechanisms and 12 of them investigated the correlation between lncRNAs and microRNAs. Taken together, this meta-analysis supports that specific lncRNAs are significantly related to the prognosis of GIC patients and may serve as novel markers for predicting the prognosis of GIC patients. Furthermore, lncRNAs may have a promising contribution to lncRNA-based targeted therapy and clinical decision-making in the future.

10558 Background: In regions with low social and economic development, gastrointestinal luminal cancer (GLC) poses a significant burden, and disparities in care are prevalent, leading to adverse disease outcomes but remain poorly studied. This study aims to assess the epidemiology of GLC in low Socio-demographic Index (SDI) regions. Methods: We analyzed temporal trends in the burden of GLC (Colorectal cancer, Esophageal cancer, Stomach cancer) using data from 2000 to 2019 from the Global Burden of Disease Study 2019. We conducted a comprehensive analysis of annual frequencies, age-standardized rates (ASRs), age-specific death rate (ASDR), and annual percentage change (APC) of luminal GI cancer incidence, death, and disability-adjusted life-years (DALYs) by sex, country, and cancer type. Results: In 2019, the frequency of incident cases due to colon cancer, esophageal cancer, and stomach cancer was 39,045, 28,132, and 43,188 respectively, with a male predominance. The number of death cases and DALYs is highest in stomach cancer, with 43,876 deaths and 1,233,251 DALYs, respectively. During 2000 to 2019, the ASDRs increased significantly for colon cancer (APC: 0.78% (0.71 to 0.84), while they decreased significantly for esophageal cancer (APC: -0.57% (-0.65 to -0.48)) and stomach cancer (APC: -1.1% (-1.26 to -0.96)). The highest ASDRs in colorectal cancer were noted in 2019 in Uganda (11.55 (9.24 - 13.75)), while the highest increase in APC in colorectal cancer was noted in Burkina Faso (APC: 1.27% (1.12 to 1.42)). Conclusions: In the preceding decade, the epidemiological landscape of GLC in low SDI countries has undergone dynamic shifts, demonstrating a heavier shift towards colorectal cancer. These findings warrant heightened awareness and strategic interventions to combat the disease.

Patients with cancer are at high risk for having mental disorders, resulting in widespread psychosocial screening efforts. However, there is a need for population-based and longitudinal studies of mental disorders among patients who have gastrointestinal cancer and particular among elderly patients. We used the SEER-Medicare database to identify patients aged ≥65 years with colorectal, pancreatic, gastric, hepatic/biliary, esophageal, or anal cancer. Earlier (12 months before or up to 6 months after cancer diagnosis) and subsequent mental disorder diagnoses were identified. Of 112,283 patients, prevalence of an earlier mental disorder was 21%, 23%, 20%, 20%, 19%, and 26% for colorectal, pancreatic, gastric, hepatic/biliary, esophageal, and anal cancer, respectively. An increased odds of an earlier mental disorder was associated with pancreatic cancer (odds ratio [OR], 1.17; 95% CI, 1.11-1.23), esophageal cancer (OR, 1.10; 95% CI, 1.02-1.18), and anal cancer (OR, 1.17; 95% CI, 1.05-1.30) compared with colorectal cancer and with having regional versus local disease (OR, 1.09; 95% CI, 1.06-1.13). The cumulative incidence of a subsequent mental disorder at 5 years was 19%, 16%, 14%, 13%, 12%, and 10% for patients with anal, colorectal, esophageal, gastric, hepatic/biliary, and pancreatic cancer, respectively. There was an association with having regional disease (hazard ratio [HR], 1.08; 95% CI, 1.04-1.12) or distant disease (HR, 1.36; 95% CI, 1.28-1.45) compared with local disease and the development of a mental disorder. Although the development of a subsequent mental disorder was more common among patients with advanced cancers, there continued to be a significant number of patients with earlier-stage disease at risk. This study suggests a larger role for incorporating psychiatric symptom screening and management throughout oncologic care.

Introduction: Venous thromboembolism (VTE) is associated with significant morbidity and mortality in cancer patients. Our study compares the mortality in hospitalized VTE patients among the four most common gastrointestinal (GI) malignancies which include esophageal, gastric, pancreatic, and colorectal cancer. Methods: A retrospective study was conducted utilizing the Nationwide Inpatient Sample database (NIS) from 2016 to 2019. Patients with VTE were identified using ICD-10 codes from all primary discharge diagnoses. Only deep venous thrombosis (DVT) and pulmonary embolism (PE) were considered. Patients with VTE were further divided into groups: esophageal cancer, gastric cancer, pancreatic cancer, and colorectal cancer, and compared with patients who did not have these malignancies. The adjusted odds ratio (aOR) was calculated using multivariate regression analysis. Results: Among 999,559 patients discharged with a VTE diagnosis, 25,775 (2.6%) had one of the four GI malignancies. Among patients with one of the four included GI malignancy diagnosis, 18,816 (73%) patients had PE and 6,959 (27%) patients had DVT. The study shows that adults admitted to the hospitals for VTE have higher mortality when compared to patients who did not have GI malignancies, with esophageal cancer having the highest inpatient mortality with an aOR of 2.701; 95% confidence interval (CI) 1.989–3.669, p value <0.000. For the remaining GI cancers, gastric cancer had an aOR 1.576; CI: 1.094–2.269, p value 0.015, and pancreatic cancer had an aOR of 1.736; 95% CI: 1.445–2.085, p value <0.000. Patients with colorectal cancer had no significant increase in the odds of mortality with aOR of 1.213; 95% CI: 0.988–1.489, p value 0.066. Conclusions: This study demonstrates that VTE in hospitalized patients with esophageal cancer is associated with greater mortality compared to other GI malignancies.

BackgroundGastrointestinal cancers are a critical global cancer burden, and tracking their trends would inform the health policies.MethodsTrends of years of life lost (YLLs) and years lived with disability (YLDs) caused by three common gastrointestinal cancers were estimated using annual percentage change (EAPC) and age-standardized rate (ASR). Data was extracted from the Global Burden of Disease study 2019.ResultsThe ASR per 100,000 population-year of YLLs caused by esophageal cancer, stomach cancer, and colorectal cancer were 137.98, 264.15, and 282.51 in 2019, respectively. Their overall trends of YLLs declined during 1990–2019, with the respective EAPCs being − 1.42 (95% Confidence Interval [CI]: − 1.71 to − 1.13), − 2.13 (95%CI: − 2.29 to − 1.96), and − 0.25 (95%CI: − 0.30 to − 0.19). Meanwhile, decreasing trends of YLDs caused by esophageal cancer and stomach cancer were observed, in which the EAPCs were − 0.67 (95%: − 0.94 to − 0.40) and − 0.85 (95%CI: − 0.97 to − 0.73), respectively. However, an increasing trend was seen in that of colorectal cancer (EAPC = 0.83, 95%CI: 0.77 to 0.89). Among countries, the largest decrease in trend of YLLs was that of stomacher cancer in the Republic of Korea (EAPC = − 5.88, 95%CI: − 6.07 to − 5.69). However, pronounced increasing trend of YLDs caused by colorectal cancer occurred in China (EAPC = 4.40, 95%CI: 4.07 to 4.72).ConclusionsDecreasing trends in YLLs and YLDs caused by esophageal cancer, stomach cancer, and colorectal cancer were observed in most countries and regions, indicating that the great progress had been achieved over the past decades. However, the cancer burden was geographical heterogeneity, and cost-effective measures were still required to decline the burden caused by gastrointestinal cancers.

This study aimed to explore the predictive values of serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 199, CA125 and CA724 in the diagnosis of gastrointestinal tumors. Among patients treated for gastrointestinal tumors at the First Affiliated Hospital of Wannan Medical College between December 2020 and March 2022, 572 patients were reviewed as the tumor group, and 700 healthy subjects from the physical examination center of the same hospital were reviewed as the control group. We evaluated the correlation between serum CEA, CA199, CA125, CA724 levels and pathological features in 572 patients with gastrointestinal tumors.The levels of serum CEA, CA199, CA125 and CA724 were compared between the two groups, and the area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the diagnostic efficacy of these markers alone and in combination. Serum CEA level was correlated with tumor stage and metastasis, and CA199 was correlated with tumor stage, lymph node involvement and metastasis. CA125 and CA724 have no correlation with tumor pathological features. The levels of serum CEA, CA199 and CA125 were significantly increased in the tumor group compared with the control group, while serum CA724 levels did not significantly differ between groups (p > 0.05). In addition, in patients with gastric cancer (GC), esophageal cancer (EC), pancreatic cancer (PC), gallbladder cancer (GBC) or colorectal cancer (CRC), the serum CEA, CA199 and CA125 levels were significantly higher than those in the control group (p < 0.05). However, serum CA724 levels were increased only in CRC patients (p < 0.05). ROC curve evaluation results showed that while CA199, CA125 and CA724 alone had poor diagnostic efficacy in the tumor group, CEA was better. Specifically, CEA had better diagnostic efficacy in GC, PC, GBC and CRC; additionally, CA199 and CA125 had better diagnostic efficacy in PC. However, CA724 showed no diagnostic value in the tumor group and the single gastrointestinal tumor group. For diagnosis with multiple-marker combinations, CEA + CA199 + CA125 had the best diagnostic performance (AUC = 0.776, AUC = 0.650, AUC = 0.896, AUC = 0.840, AUC = 0.793) in the GC, EC, PC, GBC and CRC groups, and the sensitivity of multiple-marker combined detection was better than that of single-marker detection. Serum CA724 has no diagnostic value for gastrointestinal tumors, and it cannot evaluate the pathological status of tumors. Serum CEA has excellent diagnostic efficacy in GC, PC, GBC and CRC, and its expression level is related to tumor stage and metastasis. Additionally, CA199 and CA125 have good diagnostic efficacy in PC. Among them, CA199 level was related to tumor stage, lymph node involvement and metastasis, and CA125 level was not related to pathological status. In addition, the multiple-marker combination CEA + CA199 + CA125 has the best diagnostic efficacy in GC, EC, PC, GBC and CRC.

Background: The global burden of cancer continues to increase largely because of the aging and growth of the world population alongside an increasing adoption of cancer-causing behaviors, particularly smoking, in economically developing countries. Cancer (CA) is an increasing public health burden for Ethiopia and Sub- Saharan Africa at large. In Ethiopia, hospital records show that there are more than 150,000 cancer cases per year and currently cancer accounts for 4% of all deaths. Objective: The present prospective cross-sectional study was designed to assess the prevalence of cancer and its associated risk factors in patients visiting Tikur Anbessa Specialized Hospital (TASH). Methods: A prospective cross-sectional study was carried out in patients of all age groups visiting oncology unit of TASH during the study period of November 2015 to June 2016. Sample size was computed using margin of error 5%, confidence level of 95% and estimating cancer patients visiting TASH per annum equal to 20000. The response distribution was taken 10%, considering the 2012 Cancer Prevalence Report of the WHO in East Africa 5% to 10%. The calculated sample size then was 142. Result and discussion: The mean age of the participants in our study was 42.27 year with a standard deviation of 16.8, and 2 and 86 years were the age range. More than half of the patients in the study (61.3%, n=87) were females and about (38.7%, n=55) were males. In the study area uterine, breast, cervical, colorectal and gastric CA were more prevalent in the age group between 25-49 years while Acute Lymphoblastic Leukemia (ALL) was more common in 13-18 years of age, Ewing sarcoma was seen in age between 19 and 24 years. In our findings, breast CA (14.8%, n=21) was the most frequent type of CA followed by uterine CA (14.1%, n=20), colorectal CA (11.3%, n=16), gastric cancer CA (7.7%, n=11), cervical and esophageal cancers (7%, n=10). ALL was commonly seen in students, while gastric, lung, AML, osteosarcoma; and squamous cell CA were common in farmers. Furthermore, among 20 patients who had breast CA, 65% (n=13) were used contraceptives at least once in their last 10 years period, while uterine cancer patients (40%, n=8) were used either oral or injectable contraceptives. The prevalence of breast CA was not affected by the duration of contraceptive use rather it was stable across the duration of use. Many patients who were developed colorectal CA 12 (8.5%) and gastric CA 9 (6.3%) were reported that they were regularly consuming uncooked red meat as their favorite meal. In our study, many patients were receiving radiation therapy for cases such as uterine, breast, cervical and colorectal CA while chemotherapy was predominantly used in cases such as colorectal, squamous cell, osteosarcoma, ALL, AML and lung cancer. The multinomial regression analysis result further revealed that there was a significant association between breast CA with age (25-49 year, P. value 0.016), Uterine and Cervical CA with gender (female, P. value 0.001); and eating of uncooked red raw meat with colorectal CA (P. value 0.011). Conclusion: Cancer prevalence in the study area looks greatly jeopardizing the life of many Ethiopians in association with life styles. Hence, further studies should be done. Awareness creation programs to the people, allocation of public health preventive medicine approaches and in-depth governmental involvement in the area are highly needed.

11169 Background: Cancer has historically been considered a disease of older adults, however, several reports have shown an alarming rise in the incidence of early onset cancer, particularly gastrointestinal tumors and specially colorectal cancer. To date, there are no reports in this field from Latin America. This study aims to evaluate the trends in mortality rates of the most relevant gastrointestinal tumors among young versus older people in Chile. Methods: Nationwide data from the National Department of Statistics and Health Information was obtained from the years 1997 to 2023. Cause Specific Mortality was analysed for all ages, older ( ≥ 50 years) and younger (&lt;50 years) patients for all tumors, Colorectal, Gastric, Esophagus, Pancreas, Liver and Biliary Tract cancer. The trends of rates were analyzed using Joinpoint Trend Analysis Software for calculation of the annual percentage rate change (APC). Results: Cancer-related mortality in Chile is increasing. From 1997 to 2023, for all causes, there were 2,645,132 deaths, the APC for the overall population, for all cancers is 0.96% (0.63%-1.29%, p&lt;0.001). Gastrointestinal cancer accounted for 10%, with 261,300 deaths. When analyzed by type of cancer, an increase in mortality for colorectal cancer was observed, with a rate increase 90.5% higher in younger than older adults, with an APC of 3.24% and 1.7%, respectively. This difference was more evident in female adults. Pancreatic cancer mortality rate increased from 1997 to 2015 with an APC of 0.96% in older patients, but decreased from 2015 to 2023 with an APC of -0.87%. The mortality was steady in younger patients. No differences between younger and older patients were seen for Stomach, Esophagus, Biliary tract and Liver Cancer. Stomach cancer mortality rate has decreased in younger and older patients, with an APC of -1.61% and -2.63% respectively for the period from 1997 to 2015, and -5.87% and -4.77% respectively for the period from 2015 to 2023. Esophagus cancer mortality rate has decreased in younger and older patients, with an APC of -1.09% and -2.7% respectively for the period from 1997 to 2006, and -7.71% and -4.58% respectively for the period from 2006 to 2023. Biliary tract cancer mortality rate has decreased in younger and older patients, with an APC of -1.27% and -1.61% respectively for the period from 1997 to 2006, and -7.49% and -3.39% respectively for the period from 2006 to 2023. Liver cancer mortality rate has decreased in younger and older patients, with an APC of -2.53% for younger patients and -0.13% for older patients in the period from 1997 to 2015, and -2.43% respectively for the period from 2015 to 2023. Conclusions: This study shows an increase in mortality rates of colorectal cancer among young adults that almost doubles the rate increase in older adults in Chile. Efforts to raise awareness and improve access to early detection and healthcare should be prioritized.

Association of menopausal hormone therapy with gastric and colorectal cancer risks in Korean women: A nationwide population-based cohort study

Lessons from Japan – endoscopic management of early gastric and oesophageal cancer