Global burden of upper gastrointestinal cancers: a comprehensive analysis of the high-income regions from 1990 to 2023

Background Upper gastrointestinal cancers (UGIC), mainly including esophageal cancer (EC) and stomach cancer (SC), remain major contributors to global cancer-related mortality. Although advances in cancer prevention and control have been made, UGIC continues to impose a public health burden.Methods This study comprehensively analyzed the burden of UGIC in high-income regions based on the Global Burden of Disease 2023 data. Core indicators included incidence, mortality, and disability-adjusted life years (DALYs), with age-standardized rates (ASRs).Results Compared to 1990, the case numbers of incidence, mortality, and DALYs for EC and SC have increased in the overall high-income regions in 2023. However, the ASRs declined from 1990 to 2023 (P < 0.01), especially in the early 2000s. For EC, the burden was mainly in High-income Asia Pacific, Southern Latin America, and Western Europe. For SC, the burden was concentrated in High-income Asia Pacific, with ASRs of incidence, mortality, and DALYs at 26.05, 13.13, and 267.70, respectively. The burden was higher in males and in the 95-plus age group. Aging and population were the main drivers for EC; epidemiological change was a major factor for SC. If current trends continue to 2033, the case numbers are expected to increase slowly, while ASRs are predicted to remain stable or decline, except for High-income Asia Pacific and Western Europe. Smoking, alcohol use, and unhealthy dietary habits were the top risk factors.Conclusions Overall, the burden of UGIC remained substantial in high-income regions. Future efforts should focus on males and older adults, with region-specific interventions.