The global, regional and national burden of stomach cancer and its attributable risk factors from 1990 to 2019

Abstract

We aimed to estimate the incidence, mortality, and disability-adjusted life-years (DALYs) of stomach cancer at the global, regional, and national levels. Stomach cancer resulted in 1.3 million (1.2-1.4 million) incident cases, 9.5 hundred thousand (8.7-10.4 hundred thousand) deaths, and 22.2 million (20.3-24.1 million) DALYs in 2019. The age-standardized incidence rate, death rate and DALY rate were 15.6 (14.1-17.2), 11.9 (10.8-12.8), and 268.4 (245.5-290.6) per 100,000 person-years, respectively. Between 1990 and 2019, the global age-standardized incidence rate, death rate, and DALY rate decreased by - 30.5% (- 36.7 to - 22.9), - 41.9% (- 47.2 to - 36.3), and - 45.6% (- 50.8 to - 39.8), respectively. In 2019, most of the global numbers of incidence, death and DALYs were higher among males than females. A considerable burden of stomach cancer was attributable to smoking and a high-sodium diet. Although the global age-standardized incidence and death rates have decreased, continued growth in absolute numbers in some regions, especially in East Asia, poses a major global public health challenge. To address this, public health responses should be tailored to fit each country's unique situation. Primary and secondary prevention strategies with increased effectiveness are required to reduce the incidence and mortality of stomach cancer, particularly in populations with a high disease burden.

Figure 1

Age-standardized incidence (A) and death (B) rates of stomach cancer per 100,000 population both sex, 2019. Maps were generated using R software (version 4.0.3) and ggplot2 package. [R Core Team (2019). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org; and (H. Wickham. ggplot2: Elegant Graphics for Data Analysis. Springer-Verlag New York, 2016. URL https:// https://ggplot2.tidyverse.org)].

Figure 2

Age-standardized incidence (A), death (B) and DALY (C) rates of stomach cancer per 100,000 population for 21 Global Burden Disease regions by sex, 2019. Error bars indicate the 95% uncertainty intervals (95% UI) for incidence (A), death (B) and DALYs (C). DALY disability adjusted life years.

Figure 3

The percentage change in age-standardized incidence (A), death (B) and DALY (C) rates of stomach cancer per 1,000,000 by sex for 21 Global Burden of Disease regions, 1990–2019. Error bars indicate the 95% uncertainty intervals (95% UI) for incidence (A), death (B) and DALY (C). DALYs disability adjusted life years.

Figure 4

Global counts and age-standardized incidence (A), death (B) and DALY (C) rates of stomach cancer per 100,000 population by age and sex, 2019. Error bars indicate the 95% uncertainty intervals (95% UI) for incidence (A), death (B) and DALYs (C). Shading indicates the upper and lower limits of the 95% UI. DALY disability adjusted life years.

Figure 5

Age-standardized DALY rates for stomach cancer for 21 Global Burden of Disease region by SDI, 1990–2019. Black line represents the expected age-standardized DALY rates of stomach cancer based solely on SDI. For each region, points from the left to right depict estimates from each year from 1990 to 2019. SDI  Socio-demographic Index, DALY disability adjusted life years.

Figure 6

Age-standardized DALY rates for stomach cancer for 204 countries and territories by SDI, 2019. Black line represents the expected age-standardized DALY rates of stomach cancer based solely on SDI. For each region, points from the left to right depict estimates from each year from 1990 to 2019. SDI Socio-demographic Index, DALY disability adjusted life years.

Figure 7

Proportion of stomach cancer DALYs attributable to smoking, diet high in sodium by region (A,B) and age (C,D), 2019. DALY disability adjusted life years.