[Epidemiological characteristics of gastric cancer in China and worldwide]

Objective: To analyze the epidemiological patterns and temporal trends of gastric cancer incidence and mortality in China and globally, and to formulate evidence-based prevention strategies. Methods: Based on the GLOBOCAN 2022 database, we evaluated gastric cancer incidence and mortality patterns stratified by sex, age group, geographic region and human development index (HDI). Simple linear regression and Spearman's correlation analysis assessed associations between HDI and age-standardized incidence rate (ASIR) or age-standardized mortality rates (ASMR). Temporal trends from 2002 to 2020 were described in selected regions, and projections of global gastric cancer burden by 2050 were estimated. Results: In 2022, there were estimated 969 000 new gastric cases and 660 000 deaths worldwide. The burden was higher in men than in women, with incidence peaking at ages 65-69 and mortality at 70-74. ASIR was weakly correlated with HDI (r=0.261, P＜0.001), while no significant association was found between HDI and ASMR (r=-0.005, P=0.947). China accounted for 359 000 new cases and 260 000 deaths, representing 37.0% and 39.4% of the global totals, respectively. Both ASIR (13.7/10⁵) and ASMR (9.4/10⁵) in China exceeded the global averages (9.2/10⁵ and 6.1/10⁵, respectively). Although the overall global burden is decreasing, absolute case numbers are projected to increase by 84.1% (1.78 million cases) and deaths by 91.2% (1.26 million cases) by 2050. High-HDI regions will bear greater absolute burdens, whereas low-HDI regions face steeper relative increases. In China, new cases and deaths are projected to reach 607 000 and 504 000 by 2050, rising by 69.1% and 93.8%, respectively. Conclusions: Despite a declining global trend, the burden of gastric cancer remains substantial, with notable disparities across regions, sex and age groups. Targeted strategies are urgently needed, particularly in East Asia, among males, and older populations, to mitigate the future burden.