胃肠道癌症占全球癌症死亡率的近三分之一，但这些癌症的全球综合负担仍未得到调查。我们旨在评估胃肠道癌症的全球、区域和国家负担。有关食道癌、胃癌、结直肠癌、肝癌、胰腺癌的数据和胆道癌均从 2021 年全球疾病负担数据库中提取。按性别、地区和社会人口指数（SDI）计算年龄标准化发病率（ASIR）和年龄标准化死亡率（ASDR）。2021年，消化道癌症发病526万例，死亡370万例。最大的负担来自结直肠癌，其次是胃癌、食道癌、胰腺癌、肝癌和胆道癌。我们注意到所有类型癌症的 ASIR 和 ASDR 存在地理和社会经济差异。从 2000 年到 2021 年，结直肠癌（年度百分比变化 (APC)：0.10%，95% CI 0.05% 至 0.14%）、胰腺癌（APC：0.27%，95% CI 0.14% 至 0.41%）和肝癌来自代谢功能障碍相关的脂肪性肝病（APC：0.62％，95％CI 0.58％至0.67％）和酒精相关的肝病（APC：0.26％，95％CI 0.22％至0.30％）。胰腺癌的 ASDR 增加（APC：0.18%，95% CI 0.02% 至 0.34%）。 SDI较高的国家大多数类型胃肠道癌症的发病率较高。尽管食管癌、胃癌和胆道癌的ASIR有所下降，但脂肪性肝病引起的结直肠癌、胰腺癌和肝癌的ASIR仍然升高。公共政策对于控制胃肠道癌症非常重要，最重要的是减少饮酒、乙型肝炎免疫接种和解决代谢疾病的负担。© 作者（或其雇主）2024。禁止商业重复使用。请参阅权利和权限。英国医学杂志出版。

Gastrointestinal cancers comprise nearly one-third of global mortality from cancer, yet the comprehensive global burden of these cancers remains uninvestigated.We aimed to assess the global, regional and national burden of gastrointestinal cancers.Data on oesophagus, gastric, colorectal, liver, pancreas and biliary tract cancers were extracted from the Global Burden of Disease 2021 database. Age-standardised incidence rate (ASIR) and age-standardised death rate (ASDR) were calculated by sex, region and Sociodemographic Index (SDI).In 2021, there were 5.26 million incidences and 3.70 million deaths from gastrointestinal cancer. The greatest burden is from colorectal, followed by gastric, oesophageal, pancreatic, liver and biliary tract cancer. We noted geographical and socioeconomic differences in ASIR and ASDR across all types of cancers. From 2000 to 2021, ASIR increased for colorectal cancer (annual percent change (APC): 0.10%, 95% CI 0.05% to 0.14%), pancreatic cancer (APC: 0.27%, 95% CI 0.14% to 0.41%), and liver cancer from metabolic dysfunction-associated steatotic liver disease (APC: 0.62%, 95% CI 0.58% to 0.67%) and alcohol-related liver disease (APC: 0.26%, 95% CI 0.22% to 0.30%). ASDR increased for pancreatic cancer (APC: 0.18%, 95% CI 0.02% to 0.34%). Higher SDI countries had higher incidence rates for most types of gastrointestinal cancer.Although the ASIR of oesophageal, gastric and biliary tract cancer has decreased, the ASIR still increased in colorectal, pancreatic and liver cancer from steatotic liver disease. Public policies are important for controlling gastrointestinal cancers-most importantly, reducing alcohol consumption, hepatitis B immunisation and tackling the burden of metabolic diseases.© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.