Chinese Elderly: High BMI-Linked Hepato-Biliary Cancer Burden, 2000-2021, and Future Projections to 2035

Kaiming He¹Chen Desheng¹Mingshen Zhang¹Jinsong Wang²Lei Lyu¹Dongzi Zhu³Yongwei Hu^1*Binsheng Fu^1*Linsen Ye^1*

• ¹Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
• ²Yangzhou Commission of Health, Jiangsu, China
• ³Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, Shanghai, China

The aging population and increasing prevalence of high BMI contribute to the rising burden of hepatobiliary cancers (HBCs) burden in China.However, the specific burden of HBCs among elderly individuals with high BMI in China remains inadequately understood. Thus, it is imperative to examine this burden to develop effective prevention and intervention strategies that are designed to reduce the impact of high BMI on HBCs in this vulnerable population.The burden of high BMI-related-HBCs among the elderly population in China was characterized using mortality, DALYs, the ASMR, and ASDR, as derived from the GBD 2021. The EAPC and hierarchical clustering, which were grouped by gender, were used to illustrate temporal trends. China and other countries were compared in terms of ASMR and ASDR among elderly HBC patients who were attributed to high BMI. Slope index of inequality (SII) were used for health inequality analysis. Additionally, we implemented the BAPC model to forecast trends through 2035.Results: From 2000 to 2021, both mortality and DALYs associated with high BMI-related HBCs exhibited an upward trajectory among older individuals in China, concurrently with an increase in ASMR and ASDR. In liver cancer (LC), mortality rates, ASMR and ASDR were higher in elderly males than in females. However, in gallbladder and biliary tract cancer (GBTC), elderly females exhibited higher mortality rates, ASMR and ASDR. Additionally, the burden of HBCs was characterized by gender-specific differences in growth. Older females experienced a more rapid increase in LC, whereas older males exhibited a more rapid rise in GBTC. The overall burden development pattern was consistent with the trends observed in other developing countries, with classification into the "Increase" category. SII showed positive values for HBCs, indicating a greater burden in high SDI regions.Projections indicate that mortality rates and ASMR for high BMI-related HBCs in both genders are expected to rise in the coming decade.Conclusions: This study highlighted the substantial and growing burden of high BMI related HBCs among older Chinese individuals. Our projection indicated that this burden would continuously increase over the forthcoming decade, highlighting the urgent need for effective public health interventions.