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. 2025 Jan 7;13(1):5.
doi: 10.1186/s40364-024-00720-8.

The burden of Gastric Cancer and possible risk factors from 1990 to 2021, and projections until 2035: findings from the Global Burden of Disease Study 2021

Niping Qin #  1 , Yangyan Fan #  1 , Tao Yang  2 , Zhiping Yang  3   4 , Daiming Fan  5   6
Affiliations

The burden of Gastric Cancer and possible risk factors from 1990 to 2021, and projections until 2035: findings from the Global Burden of Disease Study 2021

Niping Qin et al. Biomark Res. .

Abstract

Background and objective: Gastric cancer (GC) remains a significant global health challenge, characterized by high incidence and mortality rates, particularly in East Asia. A comprehensive understanding of the disease burden of gastric cancer is crucial for developing effective prevention and treatment strategies. However, comprehensive global assessments of the disease burden of gastric cancer remain limited. This study, based on the Global Burden of Disease (GBD) framework, systematically analyzes global trends in gastric cancer from 1990 to 2021 and projects future trends through 2035, aiming to provide scientific evidence for policymaking.

Methods: The data were derived from the Global Burden of Disease (GBD) Study 2021, covering gastric cancer (GC) incidence, mortality, disability-adjusted life years (DALYs), age-standardized incidence rates (ASIRs), age-standardized death rates (ASDRs), and age-standardized DALY rates (ASRs) across 204 countries and regions from 1990 to 2021. The Bayesian age-period-cohort model was employed to project trends up to 2035.

Results: In comparison with 1990, both the incidence and mortality of GC rose in 2021, with over 1.23 million new cases recorded globally, resulting in 954,373.60 deaths and 22,786,633.10 DALYs. Between 1990 and 2021, the ASIRs, ASDRs, and ASRs decreased by 42% (ranging from 49 to 35%), 49% (ranging from 55 to 43%), and 53% (ranging from 58 to 47%), respectively. The peak ASIRs and ASDRs in 2021 were seen in the high-middle SDI quintile. Males exhibited higher rates of ASDRs, ASIRs, and ASRs compared to females. In 2021, East Asia and high-income North America bore the largest burden of smoking-related GC, while Central Europe experienced the highest burden from high-sodium diets. Forecasts toward 2035 indicate a continued decline in both ASIRs and ASDRs.

Conclusions: Despite notable reductions in both incidence and mortality, GC remains a substantial global burden, affecting various regions and countries. Deaths and DALYs related to high-sodium diets and smoking have shown an overall decline. However, substantial regional and age-related disparities persist. Targeted interventions, such as smoking control and promoting the intake of fresh fruits and vegetables, are essential in diminishing GC risk.

Keywords: Disability-adjusted life years; Gastric cancer; Global burden of disease; Mortality; Risk factors.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study uses publicly available data from the Global Burden of Disease (GBD) database. The GBD data are anonymized and aggregated at the population level, and no individual-level information is included. Ethical approval and informed consent were not required for the use of these data. Access to the GBD database complies with all applicable data use agreements and guidelines provided by the Institute for Health Metrics and Evaluation (IHME). Consent for publication: Not applicable. This study does not involve individual-level data or any information requiring consent for publication. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Age-standardized rates for deaths (A), incidence (B) and DALYs (C) of gastric cancer across 204 countries and territories, 2021. DALYs, disability-adjusted life-years
Fig. 2
Fig. 2
Time of trend of the age-standardized death, incidence and DALYs rate of gastric cancer by sex in 1990–2021. A. The ASDR of gastric cancer. B. The ASIR of stomach cancer. C. The age-standardized DALYs rate of stomach cancer
Fig. 3
Fig. 3
The trend in age-standardized death (A), incidence (B), and DALYs (C) rates of gastric cancer in 21 GBD regions by SDI, 1990–2021. For each region, points from left to right depict estimates from each year from 1990 to 2021. The blue line represents the average expected relationship between SDI and burden estimates rates for gastric cancer based on values from each geographical region over the 1990–2021 estimation period. DALYs disability-adjusted life-years, SDI socio-demographic index
Fig. 4
Fig. 4
Proportion of gastric cancer death and DALYs risk factors by age in 2021
Fig. 5
Fig. 5
Proportion of gastric cancer deaths and DALYs attributable to risk factors, for global and regions in 2021
Fig. 6
Fig. 6
The change trends of the cancer-related disease burden by age from 1990 to 2035. A. The ASDR of gastric cancer. B. The ASIR of gastric cance
See this image and copyright information in PMC

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