Background: Effective prevention and treatment are urgently needed, since gastric cancer (GC) poses a grave threat to the health and well-being of patients. The 5 East Asian countries (China, Japan, North Korea, South Korea, and Mongolia) represent one of the most significant regions globally in terms of GC burden. Objective: The goal of this study is to examine the patterns and trends of GC across 5 East Asian countries between 1990 and 2021. Methods: We retrieved data from the Global Burden of Disease Study (GBD) 2021 regarding the prevalence, incidence, mortality, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs) associated with GC in 5 East Asian countries from 1990 to 2021. We further assessed the burden of GC according to age and sex. We used decomposition analysis to examine the changes in the number of new cases, patients, and deaths related to GC. We also used Joinpoint (Joinpoint Regression Program, Version 5.1.0) and age-period-cohort analysis methods to interpret the epidemiological characteristics of GC. Autoregressive integrated moving average model (ARIMA) and Bayesian age-period-cohort (BAPC) prediction models were used to forecast the GC burden by 2036. Results: Among the 5 East Asian countries, China recorded the highest incidence, prevalence, death, YLLs, YLDs, and DALYs in both 1990 and 2021. From 1990 to 2021, the age-standardized rates for prevalence, mortality, incidence, YLDs, YLLs, and DALYs across the 5 East Asian countries showed an overall decline, though they remained higher than the global average. In all 5 East Asian countries, individuals aged 65 years and older consistently exhibited the highest rates for prevalence, incidence, mortality, YLDs, YLLs, and DALYs. The prevalence rate in South Korea, the incidence rate in North Korea and Mongolia, and the mortality rate in China are influenced by aging, surpassing the global aging average. Conclusions: The disease burden of GC in the 5 East Asian countries has consistently ranked high over the past 3 decades, particularly among the older individuals. The burden of GC in the 5 East Asian countries is expected to present a major public health challenge, primarily driven by the large population size and the aging demographic.

In recent years, traditional Chinese medicine (TCM) has made great progress in the prevention and treatment of cancer. It has gradually revealed its characteristics and advantages in clinical practice, including alleviating clinical symptoms, prolonging survival time, decreasing the adverse effects of chemotherapy, and improving living quality. However, clinical TCM treatment of cancer lacks systematic theoretical guidance, because ancient TCM has not formed a recognized theoretical system of cognitive cancer, and there still are different opinions on the pathogenesis of cancer. Due to the complexity of cancer, the essence of cancer pathogenesis has not been described accurately by using common pathogenic factors, such as pathogenic wind, cold, dampness, summer heat, dryness, and fire. Ancient and modern TCM physicians have a similar understanding that the occurrence of cancer is related to toxin. In the 1990s, the thought of cancerous toxin was first proposed by Prof Zhou Zhongying, a TCM master based on more than 60 years of clinical practice, who used “pandemic Qi (Li-Qi) is a specific pathogenic factor of epidemic disease” in Wenyi Lun (Treatise on Pestilence) for references. The pathogenesis theory of cancerous toxin was gradually established under the guidance of the thought of cancerous toxin. It holds that the cancerous toxin, a special pathogenic factor of cancer, is the key pathogenesis of the occurrence of malignant tumors. According to the pathogenesis theory of cancerous toxin, the basic pathogenesis of malignant tumors is the accumulation of pathogenic factors and cancerous toxin, and the deficiency of the vital Qi (Zheng-Qi). Therefore, the treatment principle involves eliminating pathogenic factors, resolving cancerous toxin, and supporting the vital Qi. The anticancer detoxification methods and the classification of Chinese medicinal herbs with anticancer detoxification effects were put forward. System theory has much in common with the concepts in the theory system of TCM, such as the universal relation theory, asking for a concrete analysis of concrete conditions, the humanism thought, and so on. This article aims to describe, review, and analyze the pathogenesis theory of cancerous toxin based on system theory for clinical practices.

Colorectal cancer (CRC) is a leading global cause of cancer morbidity and mortality, yet how its burden has shifted during rapid demographic and lifestyle change in East Asia remains poorly characterized. This study fills that gap by examining long‑term trends and drivers of CRC burden in the selected East Asian countries-China, Japan, North Korea, South Korea, and Mongolia-between 1990 and 2021, and by projecting future burden through 2036. We obtained data from the Global Burden of Disease (GBD) Study 2021 on CRC-related prevalence, incidence, mortality, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs) in the selected countries, further assessed by age and sex. We quantified contributions of population growth, aging and epidemiological change via decomposition analysis, characterized temporal trends with Joinpoint and age-period-cohort analysis, and generated forecasts to 2036 using Autoregressive Integrated Moving Average and Bayesian age-period-cohort approaches. Although absolute CRC burden rose across the region-driven largely by population aging-with China exhibiting the highest numbers and Japan exhibiting the highest age‑standardized rates. Older adults bore the greatest share of burden. Decomposition and modeling indicate that demographic shifts have been the predominant force behind increasing CRC counts, and projected trends suggest the regional burden will remain substantial without targeted action. This study provides novel, region‑specific evidence that demographic aging is the principal driver of rising CRC burden in East Asia. The findings highlight an urgent need for tailored prevention, screening and resource planning focused on aging populations to alter the projected trajectory.

Gastrointestinal cancers account for 11.6 % of all cancers, and are the second most frequently diagnosed type of cancer worldwide. Traditional Chinese medicine (TCM), together with Western medicine or alone, has unique advantages for the prevention and treatment of cancers, including gastrointestinal cancers. Syndrome differentiation and treatment are basic characteristics of the theoretical system of TCM. TCM syndromes are the result of the differentiation of the syndrome and the basis of treatment. Genomics, transcriptomics, proteomics, metabolomics, intestinal microbiota, and serology, generated around the central law, are used to study the biological basis of TCM syndromes in gastrointestinal cancers. This review summarizes current research on the biological basis of TCM syndrome in gastrointestinal cancers and provides useful references for future research on TCM syndrome in gastrointestinal cancers.

Background: Hepatocellular carcinoma (HCC) is the most prevalent form of primary liver cancer, characterized by high incidence and mortality rates. Yangzheng-Xiaoji capsules (YXC) have been widely used in Traditional Chinese Medicine for the treatment of HCC in China; however, the composition of compounds in YXC and its underlying anti-tumor mechanisms remain unclear. Methods: High-performance liquid chromatography quadrupole time-of-flight mass spectrometry (HPLC-Q-TOF-MS/MS) was used to analyze the composition of YXC. An MHCC97H orthotopic mouse model of HCC was used to assess the therapeutic efficacy of YXC and its impact on the p53-induced apoptotic pathway and the PI3K/Akt pathway. YXC-mediated serum was prepared, and its optimal intervention concentration was determined using the MTT assay. The effects of YXC-mediated serum on apoptosis in MHCC97H cells, as well as on the p53-induced apoptotic pathway and the PI3K/Akt pathway, were investigated and verified through the TUNEL assay. Results: HPLC-Q-TOF-MS/MS analysis identified 58 components in YXC. In vivo, YXC significantly improved body weight, dietary status, survival rate, and tissue pathology, inhibited xenografts growth, promoted apoptosis of HCC cells, activated the p53-induced apoptotic pathway, and inhibited the PI3K/Akt signaling pathway with good safety. In vitro, YXC-mediated serum showed similar efficacy. When 20% YXC-mediated serum was added to MHCC97H cells, the increased apoptosis was significantly rescued by the addition of p53 inhibitor (PFT-α) or PI3K activator (740Y-P). Conclusion: The results of this study indicate that YXC exhibits anti-proliferative and pro-apoptotic pharmacological activity via activating the p53-induced apoptotic pathway and suppressing the PI3K/Akt pathway.

Background: Pancreatic cancer (PC) presents a significant challenge for prevention and treatment, posing a serious threat to the health and lives of patients. The five East Asian countries (China, Japan, North Korea, South Korea, and Mongolia) represent one of the most significant regions globally in terms of PC burden. Methods: We retrieved data from the Global Burden of Disease (GBD) Study 2021 regarding the prevalence, incidence, mortality, years lived with disability (YLDs), years of life lost (YLLs), and disability‐adjusted life years (DALYs) associated with PC in these five East Asian countries from 1990 to 2021. We employed joinpoint, age‐period‐cohort (APC), and decomposition analysis methods to assess the epidemiological characteristics of PC. To project the future burden of PC through 2036, we applied two prediction models: Autoregressive Integrated Moving Average (ARIMA) and Bayesian age‐period‐cohort (BAPC) models. Results: China recorded the highest incidence, prevalence, mortality, YLLs, YLDs, and DALYs among the five East Asian countries in both 1990 and 2021. Japan exhibited the highest age‐standardized incidence rate (ASIR), age‐standardized mortality rate (ASMR), age‐standardized prevalence rate (ASPR), and age‐standardized YLDs rate in both 1990 and 2021. Mongolia experienced significant increases in the number and rates of incidence, prevalence, death, YLLs, YLDs, and DALYs from 1990 to 2021. The age group with the highest prevalence, incidence, mortality, YLDs, YLLs, and DALYs rates across the five East Asian countries was consistently those aged 70 and older. The incidence rate across the five countries is influenced by aging populations, surpassing global averages. Projections for 2030 and 2036 suggest that Japan will have the highest ASPR (13.23 in 2030 and 13.85 in 2036), ASIR (12.14 in 2030 and 12.53 in 2036), and ASMR (10.97 in 2030 and 11.39 in 2036) among the countries. Conclusion: The disease burden of PC in the five East Asian countries has steadily increased over the past three decades, particularly among older adults due to population aging.