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a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2023; 77(5): 394–408. doi: 10.48095/ccgh2023394.

Trends in premature mortality from digestive system cancers in Slovakia in the years 2011–2020: 8 diagnoses over 10 years

Tomáš Koller  1, Anna Baráková2

+ Affiliation


Introduction and objectives: Slovakia ranks among the leaders in preventable deaths, but a systematic analysis of the share of digestive system cancers (DSCs) and their trends has been lacking. We analyzed data on mortality from DSCs in Slovakia in the years 2011–2020 with an emphasis on premature deaths, sex differences, and trends for individual locations. Material and methods: Data in the years 2011–2020 by ICD-10 codes C15–C26 aggregated by age subgroups (<50 years, <65 years, <75 years), sex, and individual locations were available. The crude death rate was calculated per 100,000 inhabitants and linear regression was used for the annual percentage change in mortality. Results: We recorded 46,508 deaths; 27,146 were men and 19,362 women with an average age of 70,5 ±11,6. Deaths under the age of 50, 65, and 75 made up 4.1%, 29.8%, and 60.4% of all deaths from DSCs. Among all deaths due to cancer under the age of 65, deaths from DSCs accounted for one-third in men and one-quarter in women. Under the age of 75, colorectal (41%), pancreatic (21%), stomach (12.8%), and liver (10%) cancers dominated the proportions of locations. The average age of death was significantly lower in men and increased over the decade for all locations. In women, the trend was identical, except for the liver, intrahepatic bile ducts (decrease by 1 year), bile ducts, and stomach (no change). Under the age of 65 in all cases, the average annual mortality rate decreased by 1.7%. In men, it decreased for locations in the esophagus, stomach, colorectum (–1.8%/year), liver, and gallbladder. In women, for colorectum (–1.8%/year) and gallbladder (–6%/year). In contrast, in the entire population mortality increased for locations in the pancreas (+2.3 to 2.8%/year) and bile ducts (+4.4 to 7.3%/year). Conclusion: DSCs are significant burden causing preventable deaths. Some favorable trends (stomach, gall bladder) are simultaneously followed by unfavorable ones (biliary tract, pancreas). In the global context of an aging population and increasingly longer exposure to risk factors, we need to introduce effective societal preventive measures as well as flexible adaptation of our healthcare systems.


digestive system cancers, premature mortality, trend, adult, male, female

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1. Rose TC, Pennington A, Kypridemos C et al. Analysis of the burden and economic impact of digestive diseases and investigation of research gaps and priorities in the field of digestive health in the European Region – White Book 2: Executive summary. United European Gastroenterol J 2022; 10(7): 657–662. doi: 10.1002/ueg2.12298.
2. Health at a Glance 2021 : OECD Indicators | Health at a Glance | OECD iLibrary. 2023 [online]. Dostupné z: https: //
3. Arnold M, Abnet CC, Neale RE et al. Global Burden of 5 Major Types of Gastrointestinal Cancer. Gastroenterology 2020; 159(1): 335–349.e15. doi: 10.1053/j.gastro.2020.02.068.
4. Národné centrum zdravotníckych informácií. Zdravotnícka ročenka Slovenskej republiky 2020.
5. Bosetti C, Levi F, Rosato V et al. Recent trends in colorectal cancer mortality in Europe. Int J Cancer 2011; 129(1): 180–191. doi: 10.1002/ijc. 25653.
6. Chloupková R, Ngo O, Suchánek et al. Colorectal cancer screening program in the Czech Republic – 2021 quality indicators evaluation. Gastroent Hepatol 2022; 76(5): 379–385. doi: 10.48095/ccgh2022379.
7. Hrčka R, Bátovský M. Six years of the National program for colorectal cancer screening in Slovakia. Gastroent Hepatol 2018; 72(5): 415–420. doi: 10.14735/amgh2018415.
8. Bureš J, Kopáčová M, Koupil I et al. Significant decrease in prevalence of Helicobacter pylori in the Czech Republic. World J Gastroenterol 2012; 18(32): 4412–4418. doi: 10.3748/wjg.v18.i32.4412.
9. Rác M, Janičko M, Koller T et al. Ultra-processed food – a threat to liver health. Gastroent Hepatol 2023; 77(2): 123–129. doi: 10.48095/ccgh 2023123.
10. The world bank. Total alcohol consumption per capita, male (liters of pure alcohol, projected estimates, male 15+ years of age. 2023 [online]. Dostupné z: https: //
11. Eurostat, European Comission. Avoidable mortality: OECD/Eurostat lists of preventable and treatable causes of death (January 2022 version). 2022 [online]. Dostupné z: http: //
12. Global Cancer Observatory. 2023 [online]. Dostupné z: https: //
13. Ilic I, Ilic M. International patterns in incidence and mortality trends of pancreatic cancer in the last three decades: A joinpoint regression analysis. World J Gastroenterol 2022; 28(32): 4698–4715. doi: 10.3748/wjg.v28.i32.4698.
14. Ugai T, Sasamoto N, Lee HY et al. Is early-onset cancer an emerging global epidemic? Current evidence and future implications. Nat Rev Clin Oncol 2022; 19(10): 656–673. doi: 10.1038/s41571-022-00672-8.
15. Lu L, Mullins CS, Schafmayer C et al. A global assessment of recent trends in gastrointestinal cancer and lifestyle‐associated risk factors. Cancer Commun 2021; 41(11): 1137–1151. doi: 10.1002/cac2.12220.
16. Mikoviny Kajzrlíková I, Vítek P, Klvaňa P et al. Early onset colorectal cancer – personal experience 2012–2021. Gastroent hepatol 2023; 77(3): 221–224. 10.48095/ccgh2023221.
17. Tanaka LF, Figueroa SH, Popova V et al. The Rising Incidence of Early-Onset Colorectal Cancer. Dtsch Arztebl Int 2023; 120: 59–64. doi: 10.3238/arztebl.m2022.0368.
18. Lumish MA, Cercek A. Practical Considerations in Diagnosing and Managing Early-Onset GI Cancers. J Clin Oncol 2022; 40(24): 2662–2680. doi: 10.1200/JCO.21.02708.
19. Pan H, Zhao Z, Deng Y et al. The global, regional, and national early-onset colorectal cancer burden and trends from 1990 to 2019: results from the Global Burden of Disease Study 2019. BMC Public Health 2022; 22: 1–17. Dostupné z: https: //
20. Yao H, Sokas C, Welch HG. Rising Incidence of Cancer of the Small Intestine: Overdiagnosis and Better Diagnosis of Low-lethality Disease. Gastroenterology 2022; 162(6): 1749.e2–1751.e2. doi: doi: 10.1053/j.gastro.2022.01.012.
21. Fedewa SA. Why Is Cancer of the Small Intestine Increasing? Gastroenterology 2022; 162(6): 1593–1594. doi: 10.1053/j.gastro.2022.03.005.
22. Eurostat. Causes of death – malignant neoplasms of colon, rectosigmoid junction, rectum, anus and anal canal, residents, 2019. 2023 [online]. Dostupné z: Cancer statistics – specific cancers – Statistics Explained (
23. Evaluační zpráva programu screeningu kolorektálního karcinomu. 2022 [online]. Dostupné z: evaluacni-zprava-programu-screeningu-kolorektalniho-karcinomu-v-cr.pdf (
24. Wands J. Hepatocellular carcinoma and sex. N Engl J Med 2007; 357(19): 1974–1976. doi: 10.1056/NEJMcibr075652.
25. Antwi SO, Mousa OY, Patel T. Racial, Ethnic, and Age Disparities in Incidence and Survival of Intrahepatic Cholangiocarcinoma in the United States; 1995–2014. Ann Hepatol 2018; 17(4): 604–614. doi: 10.5604/01.3001.0012.0929.
26. Bertuccio P, Malvezzi M, Carioli G et al. Global trends in mortality from intrahepatic and extrahepatic cholangiocarcinoma. Hepatol 2019; 71(1): 104–114. doi: 10.1016/j.jhep.2019.03.013.
27. Yao KJ, Jabbour S, Parekh N et al. Increasing mortality in the United States from cholangiocarcinoma: An analysis of the National Center for Health Statistics Database. BMC Gastroenterol 2016; 16: 1–8. doi: 10.1186/s12876-016- 0527-z.
28. Gad MM, Saad AM, Faisaluddin M et al. Epidemiology of Cholangiocarcinoma; United States Incidence and Mortality Trends. Clin Res Hepatol Gastroenterol 2020; 44: 885–893. doi: 10.1016/j.clinre.2020.03.024.
29. Huang J, Lok V, Ngai CH et al. Worldwide Burden of, Risk Factors for, and Trends in Pancreatic Cancer. Gastroenterology 2021; 160(3): 744–754. 10.1053/j.gastro.2020.10.007.

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