State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Gastroenterology. 2021 Jul;161(1):116-127.e8. doi: 10.1053/j.gastro.2021.03.023. Epub 2021 Mar 18.
BACKGROUND & AIMS: The long-term trend in gastric cancer rates has rarely been reported from a global perspective. We aimed to explore the past temporal trends (1988-2012) in gastric cancer incidence rates in 43 countries and to predict future trends (2012-2030).
Data on yearly gastric cancer incidence by age group and sex were drawn from 108 cancer registries in 43 countries in the Cancer Incidence in Five Continents Time Trends (CI5plus) database. Age-standardized incidence rates per 100,000 persons were computed from 1988-2012. The number of new cases and incidence rates were predicted to 2030 using the Bayesian age-period-cohort model.
Persistent decreasing trends in gastric cancer incidence rates were observed from 1988-2012 worldwide, with an overall average annual percentage change of -2.1% (95% confidence interval, -2.5--1.7). The trends will continue or remain stable until 2030 in most of the selected countries except for Ecuador and Lithuania, whose gastric cancer incidence rates will experience substantially increasing trends in the next several decades.
The incidence rates of gastric cancer are expected to decrease through 2030 in most countries except Ecuador and Lithuania. Reductions in smoking and Helicobacter pylori prevalence and improvement in diet probably contributed to the decrease. Gastric cancer still represents a major cancer burden worldwide, and the large number of gastric cancer cases worldwide may still call for lifestyle interventions in terms of smoking and diet and massive efforts for H pylori screening and treatment, especially in countries with predicted increasing incidence rates of gastric cancer.
从全球角度来看，胃癌发病率的长期趋势鲜有报道。本研究旨在探讨 43 个国家 1988-2012 年胃癌发病率的过去时间趋势，并预测未来趋势（2012-2030 年）。
从癌症发病率五地区时间趋势（CI5plus）数据库中 108 个癌症登记处获取了 43 个国家按年龄组和性别划分的胃癌发病率的年度数据。计算了 1988-2012 年每 10 万人的年龄标准化发病率。使用贝叶斯年龄-时期-队列模型预测 2030 年的新发病例数和发病率。
1988-2012 年，全球范围内胃癌发病率呈持续下降趋势，总体平均年变化率为-2.1%（95%置信区间，-2.5%~-1.7%）。除厄瓜多尔和立陶宛外，大多数选定国家的趋势将继续或保持稳定，直到 2030 年，这两个国家在未来几十年内胃癌发病率将呈大幅上升趋势。
除厄瓜多尔和立陶宛外，预计大多数国家的胃癌发病率将在 2030 年之前下降。吸烟和幽门螺杆菌流行率的降低以及饮食的改善可能促成了这一下降。胃癌仍然是全球主要的癌症负担，全球大量的胃癌病例可能仍需要通过生活方式干预来控制吸烟和饮食，以及对幽门螺杆菌进行大规模筛查和治疗，尤其是在胃癌发病率预计呈上升趋势的国家。
