Gastric cancer in China: Epidemiology, risk factors, and screening

Gastric cancer (GC) remains a significant public health burden in China, accounting for a high proportion of global incidence and mortality. Generally, the incidence and mortality of GC demonstrate marked demographic and geographic disparities in China, with higher rates in males, older adults and rural residents. Helicobacter pylori (H. pylori) infection serves as the main risk factor and contributes to approximately three-quarters of GC cases in China. Large-scale randomized controlled intervention trials in high-risk areas have provided robust evidence to support H. pylori eradication as an effective primary prevention strategy. Other established risk factors include high-salt diet and inadequate consumption of fresh fruits and vegetables. For secondary prevention, several national screening programs utilizing endoscopic examination have been conducted in high-risk populations, which were proven effective in early detection and mortality reduction. However, GC prevention and control in China still face great challenges, including increasing antibiotic resistance, limited screening coverage, and regional disparities in healthcare resources. Further efforts are urgently needed to integrate personalized risk prediction, family-based H. pylori control, and optimized cost-effective screening strategies for precision prevention to finally reduce the burden of GC.