Smoking-attributable gastrointestinal cancer burden in
Brazil, Russia, India, China and South Africa (BRICS) and
Associated Economies: A Global Burden of Disease study
analysis 1990–2023

Wei Jiang; Yinglin Wang; Rui Cheng

doi:10.18332/tpc/221523

July/2026 vol. 12

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Smoking-attributable gastrointestinal cancer burden in Brazil, Russia, India, China and South Africa (BRICS) and Associated Economies: A Global Burden of Disease study analysis 1990–2023

Wei Jiang ¹

Yinglin Wang ¹

Rui Cheng ¹

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1. Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China 2. State Key Laboratory of Digestive Health, Beijing 100050, China 3. National Clinical Research Center for Digestive Disease, Beijing 100050, China 4. Beijing Key Laboratory of Early Gastrointestinal Cancer Medicine and Medical Devices, Beijing 100050, China

These authors had equal contribution to this work

Submission date: 2026-03-19

Final revision date: 2026-05-06

Acceptance date: 2026-05-06

Publication date: 2026-07-13

Corresponding author

Rui Cheng

Tob. Prev. Cessation 2026;12(July):38

DOI: https://doi.org/10.18332/tpc/221523

Article (PDF)

Supplementary files

Jiang et al (1383) Supplementary file.pdf

References (26)

KEYWORDS

gastrointestinal cancers

smoking

BRICS economies

mortality

disability-adjusted life years

TOPICS

ABSTRACT

Introduction:
BRICS and associated economies have a considerable share of the world’s population and cancer burden; however, long-term trends, heterogeneity and inflection points of smoking-attributable gastrointestinal (GI) cancers are still unclear. This retrospective population-based secondary analysis utilized Global Burden of Disease (GBD) 2023 data to investigate the mortality, disability-adjusted life years (DALYs) and age-standardized rates (ASRs) of smoking-attributable GI cancers among 11 BRICS and associated economies in 1990–2023, and to provide data-driven evidence for epidemiological and clinical prevention research on smoking-related GI cancers.

Methods:
This secondary analysis used 2023 GBD data, which included five main types of GI cancers caused by smoking: esophageal, stomach, colon and rectum, liver and pancreas cancers. Mortality, DALYs and ASRs were analyzed at the global, region and country levels. Joinpoint regression was used to compute annual percentage change (APC) and average annual percentage change (AAPC).

Results:
The total number of smoking-attributable GI cancer deaths in the study regions rose from 236305.08 in 1990 to 328324.75 in 2023 and total DALYs increased from 6.53 million to 8.08 million; the age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) decreased with an AAPC of −1.44% and −1.48%, respectively. Brazil and China experienced the greatest declines in ASMR. India, Egypt and Ethiopia showed an increasing trend. Esophageal cancer was still the main cause of death and pancreatic cancer had the highest increase in mortality rate. Age-stratified analysis showed that the 20–29 years age group had a growing disease burden and the 40–64 years group had the largest decrease in DALYs. For people aged >75 years, the decline of disease burden decelerated.

Conclusions:
The burden of smoking-attributable GI cancers in BRICS and associated economies has increased with rising absolute mortality and DALYs and falling ASRs. Regional disparities, age trends and rising youth risks reveal marked epidemiological differences in GI cancer burden.

ABBREVIATIONS

ABBREVIATIONS ASMR: age-standardized mortality rate per 100000, AAMR: all ages mortality rate per 100000, DALYs: disabilityadjusted life years, ASDR: age-standardized DALYs rate per 100000, AADR: all ages DALYs rate per 100000, ASR: age-standardized rate per 100000, YLL: years of life lost, APC: annual percentage change, AAPC: average annual percentage change

ACKNOWLEDGEMENTS

The authors thank the investigators and staff who participated in the GBD study.

CONFLICTS OF INTEREST

The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.

FUNDING

This work was supported by: Beijing Research Ward Excellence Program (Grant number:BRWEP2024W162020100 and BRWEP2024W162020113); The National Key Research and Development Program of China (Grant number:2024YFF1207001).

ETHICAL APPROVAL AND INFORMED CONSENT

Ethical approval and informed consent were not required for this study as it is a secondary analysis of existing data.

DATA AVAILABILITY

The data supporting this research can be found in the Supplementary file.

AUTHORS' CONTRIBUTIONS

All authors contributed to the conception and design of the study, acquisition of data, or analysis and interpretation of data, drafted or revised the article critically for important intellectual content. All authors read and approved the final version of the manuscript.

PROVENANCE AND PEER REVIEW

Not commissioned; externally peer reviewed.

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REFERENCES (26)

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