Abstract 793: Potential impact of time trend of lifestyle factors on burden of gastrointestinal cancer in China

Abstract BACKGROUND: Colorectal, esophageal, stomach, and liver cancers are four major gastrointestinal (GI) cancers that have 2-3 times the age-standardized incidence rates in China compared to the global average. Examining the time trend of risk factors associated with GI cancer would help us project the future trend of GI cancer incidence in China and guide public health policymaking. METHODS: We estimated the time trend of relevant dietary and lifestyle factors in China based on data from the China Health and Nutrition Survey 1991-2011. We applied the comparative risk assessment method to estimate the population attributable fraction (PAF%) and the absolute number of GI cancer events attributable to all non-optimal levels of each risk factor. We have also projected the lifestyle factors and the estimated burden of GI cancer in the next 30 years. RESULTS: In 2011, the overall estimated PAF% by all risk factors under study is 73% for esophageal cancer, 59% for colorectal cancer, 47% for gastric cancer, and 35% for liver cancer. Smoking, low fruit intake, high red meat consumption, high body mass index (BMI), and high alcohol consumption were the top 5 contributors to GI cancer incidence in China; each accounted for 173, 134, 132, 125, and 91 thousand GI cancer cases, respectively. For specific cancer sites, high red meat consumption accounted for the most cases of colorectal cancer in 2011 (N = 51,405; PAF% = 19%) and is projected to have higher PAF% from 15% in 1997 to 23% in 2041. High BMI is responsible for the most liver cancer cases in 2011 (N = 55,244; PAF% = 17%) and has an increasing trend in expected PAF% from 7% in 1991 to 20% in 2041; low fruit intake is the top contributor for esophageal cancer in 2011 (N = 85,345; PAR% = 29%) with a downward trend in the next few decades (PAF% from 33% in 1997 to 23% in 2041); high sodium intake represented the highest PAF% for gastric cancer in 2011 (68,858 cases, PAF% = 17%), but is expected to be overpassed by smoking, high BMI, and red meat consumption in 2015-2025. CONCLUSIONS: China has witnessed significant transitions in lifestyle, including diet, physical activity, and obesity. The impact of the lifestyle risk factors on the risk of GI cancer has been increasing from 1991 to 2011 and is projected to continue growing. High red meat consumption and high BMI call for extra attention as they are among the top contributors to GI cancer and are expected to have stronger impacts in the next 30 years in China. Citation Format: You Wu, Yanping Li, Edward Giovannucci, Frank B. Hu. Potential impact of time trend of lifestyle factors on burden of gastrointestinal cancer in China [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 793.