尽管消化道癌症对公共卫生构成了巨大挑战，但了解中国消化道癌症的负担数据匮乏。我们旨在提供中国三十年来主要消化道癌症负担的最新估计。根据GLOBOCAN 2020数据库，2020年中国新诊断了1,922,362例消化道癌症病例，有1,497,388人死亡，结直肠癌的发病率最高（555,480例新病例；23.90/100,000年龄标化发病率[ASIR]），肝癌的死亡率最高（391,150例死亡；17.20/100,000年龄标化死亡率[ASMR]）。食管、胃和肝癌的年龄标化发病率（ASR）、死亡率和残疾调整寿命年（DALY）率总体上有所下降（1990-2019，年均百分比变化[AAPC]<0%，p<0.001），但近年来已趋于趋平或逆转，令人担忧。在未来十年内，中国的消化道癌症谱将继续转变，以快速增加的结直肠和胰腺癌为特征，除了食管、胃和肝癌的高负担外。发现高身体质量指数是消化道癌症风险因素中增长最快的（估计年均百分比变化[EAPC]:2.35%-3.20%，所有p<0.001），而吸烟和饮酒仍是男性消化道癌症相关死亡的主要因素。总之，中国的消化道癌症正在挑战医疗保健系统，负担日益增加且呈转型趋势。需要综合策略实现健康中国2030目标。版权所有©2023 Elsevier B.V. 发布。

Although gastrointestinal (GI) cancers pose a great challenge to public health, data are scant for understanding the burden of GI cancers in China. We aimed to provide an updated estimate of the burden of major GI cancers in China over three decades. According to the GLOBOCAN 2020 database, 1,922,362 GI cancer cases were newly diagnosed and 1,497,388 deaths occurred in China in 2020, with the highest incidence in colorectal cancer (555,480 new cases; 23.90/100,000 age-standardized incidence rate [ASIR]) and the highest mortality in liver cancer (391,150 deaths; 17.20/100,000 age-standardized mortality rate [ASMR]). The age-standardized rates (ASRs) in incidence, mortality, and disability-adjusted life year (DALY) rates for esophageal, gastric, and liver cancers have declined overall (1990-2019, average annual perventage change [AAPC] < 0%, p < 0.001) but have become flattened or reversed in recent years, alarmingly. The spectrum of GI cancers in China will continue transitioning in the next decade, characterized by rapid increases in colorectal and pancreatic cancers in addition to a high burden of esophageal, gastric, and liver cancers. High body-mass index was found to be the fastest-growing risk factor for GI cancers (estimated annual perventage change [EAPC]: 2.35%-3.20%, all p < 0.001), whereas smoking and alcohol consumption remained the top contributors to GI cancer-related deaths in men. In conclusion, GI cancers in China are challenging the healthcare system with a growing burden and a transitioning pattern. Comprehensive strategies are needed to reach the Healthy China 2030 target.Copyright © 2023. Published by Elsevier B.V.