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The global economic burden of digestive tract diseases and cancers from 2020 to 2050

Nature Health (2026)Cite this article

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Abstract

Digestive tract diseases and neoplasms (DTDNs) constitute a major global health burden with poorly quantified economic impact. Here, using health-augmented macroeconomic modelling across 190 countries (2020–2050), we estimated DTDNs’ economic burden by comparing scenarios with and without complete disease eradication, incorporating educational heterogeneity, workforce participation variations and treatment cost impacts on capital accumulation. DTDNs will impose a US$26.1 trillion global economic burden, equivalent to 0.65% annual Gross Domestic Product tax. Cirrhosis and chronic liver diseases contribute the largest share (30.2%), followed by colorectal cancer (11.6%), gallbladder diseases (8.8%), stomach cancer (7.3%) and hernias (6.7%). China (US$8.6 trillion) and the USA (US$4.0 trillion) experience the largest absolute impacts. Upper-middle-income countries bear 46.2% of economic consequences. Disease patterns shift from infection-related to lifestyle-related conditions as income levels rise. Physical capital losses constitute 76% of burden in high-income countries versus 1% in low-income countries. The substantial and unevenly distributed global economic burden of DTDNs, particularly liver diseases, warrants targeted prevention strategies that could yield significant economic returns globally.

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Fig. 1: Macroeconomic burden due to DTDNs from 2020 to 2050.
Fig. 2: Type of DTDNs with the largest macroeconomic cost in each country.
Fig. 3: Economic burden of 16 DTDNs by World Bank income group, 2020–2050.

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Data availability

All data used in this study are publicly available from existing repositories and databases. Detailed descriptions of the data sources, access links and processing procedures are provided in the Methods. No new datasets were generated for this study. The original data used in the study and the generated data are publicly available via GitHub at https://github.com/hxj0594/HAM_DTDNs. Source data are provided with the paper.

Code availability

All code and data used for analysis are publicly available via GitHub at https://github.com/hxj0594/HAM_DTDNs.

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Acknowledgements

We thank everyone who contributed to this research, especially those who provided the foundational model framework.

Author information

Author notes

  1. These authors contributed equally: Xiaojie Huang, Qingwei Zhang, Haoliang Cui, Zeyu Li, Jianyi Zhang.

Authors and Affiliations

  1. Department of Spleen and Stomach, the Second People’s Hospital Afiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China

    Xiaojie Huang

  2. Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

    Qingwei Zhang, Zeyu Li, Yiming Song & Xiaobo Li

  3. Department of Global Health, School of Public Health, Peking University, Beijing, China

    Haoliang Cui & Jianyi Zhang

  4. Digestive Endoscopy Center, Fujian Provincial Hospital Affiliated to Fuzhou University, Fuzhou, China

    Jingjing Chen, Guifen Chen, Xiaolu Lin & Wanyin Deng

  5. Department of Clinical Medicine, Fujian Medical University, Fuzhou, China

    Jingjing Chen & Guifen Chen

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Contributions

X.H., Q.Z., H.C., Z.L. and J.Z. contributed equally to the study and are joint first authors. X. Lin, X. Li and W.D. conceived and designed the study. X.H., Q.Z., H.C. and J.Z. supervised the study and performed the statistical analysis. All authors contributed to the acquisition, analysis or interpretation of data. X.H., Q.Z., H.C. and J.Z. drafted the paper. All authors revised the report and approved the final version before submission. X. Lin, X. Li and W.D. contributed equally to this work and are the joint corresponding authors. W.D. is the guarantor. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

Corresponding authors

Correspondence to Xiaolu Lin, Xiaobo Li or Wanyin Deng.

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Nature Health thanks Simiao Chen and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. Peer reviewer reports are available. Primary Handling Editor: Lorenzo Righetto, in collaboration with the Nature Health team.

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Huang, X., Zhang, Q., Cui, H. et al. The global economic burden of digestive tract diseases and cancers from 2020 to 2050. Nat. Health (2026). https://doi.org/10.1038/s44360-026-00113-1

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