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Gastric Cancer in China, 1990 to 2023: Trends, Modifiable Risks, and Prevention Priorities.

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Gastric cancer (GC) burden in China shows declining mortality rates but increasing case numbers, particularly in older males. Intensified risk factor control and targeted screening are crucial for managing this shift.

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Area of Science:

  • Epidemiology
  • Public Health
  • Oncology

Background:

  • Gastric cancer (GC) is a significant cause of cancer mortality in China.
  • Long-term trends in GC incidence, mortality, prevalence, and DALYs require quantification.

Purpose of the Study:

  • To quantify long-term trends in GC incidence, mortality, prevalence, and DALYs in China from 1990 to 2023.
  • To profile the burden attributable to key behavioral risks associated with GC.

Main Methods:

  • Utilized Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 estimates for China.
  • Employed Joinpoint log-linear regression to analyze trends in age-standardized rates (ASIR, ASMR, ASPR, ASDR) by sex and age groups.

Main Results:

  • In 2023, China recorded 575,712 incident GC cases and 381,500 deaths.
  • While deaths and DALYs decreased significantly since 1990, incident and prevalent cases increased.
  • Males and individuals aged 75+ experienced the highest and slowest declining GC burdens; smoking, high sodium, and alcohol intake were major contributors.

Conclusions:

  • China's GC burden is shifting towards lower mortality rates but higher case numbers, concentrated in older males.
  • There is a critical need for enhanced control of risk factors like smoking, high sodium, and alcohol consumption.
  • Risk-adapted endoscopic screening strategies are essential for addressing the evolving GC landscape.