Xie Xiangying, Su Juan, Wang Wei, Wei Huiling, Zhou Qian, Su Ying, Zhang Lili
Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China.
Department of Geratology, Renmin Hospital of Wuhan University, Wuhan, China.
J Gastroenterol Hepatol. 2025 Jun;40(6):1500-1514. doi: 10.1111/jgh.16956. Epub 2025 Apr 1.
To study the corresponding strategies to control stomach cancer, a comprehensive assessment of the disease burden is required. Herein, we present long-term trends in the burden of stomach cancer in China over the past three decades, as well as its epidemiological features.
We characterized the burden of stomach cancer in China using the GBD 2021 methods and results, based on prevalence, incidence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) estimated using the DisMod-MR 2-1. We also used joinpoint and age-period-cohort (APC) analysis methods to interpret the epidemiological characteristics of stomach cancer, project the disease burden of stomach cancer in China over the next decade, and compare these trends with global prevalence patterns.
The age-standardized incidence (ASIR) and mortality rates (ASMR) in both sexes changed from 48.03 (40.21, 56.69) to 29.05 (22.42, 36.2) and from 46.05 (38.88, 54.43) to 21.51 (16.66, 26.61) per 100 000 people in China from 1990 to 2021. The age-standardized DALY rate in China decreased from 1181.61 (978.38, 1390.89) per 100 000 people in 1990 to 501.26 (387.29, 627.98) per 100 000 people in 2021. The average annual percentage change (AAPC) in age-standardized incidence, prevalence, and mortality rates for stomach cancer in China were -1.61 (95% CI: -1.73, -1.48), -0.50 (95% CI: -0.67, -0.32), and -2.44 (95% CI: -2.62, -2.26). The effects of age, period, and cohort on mortality rates differed.
In the next decade, China's ASIR and ASMR for stomach cancer will continue to decline. However, despite the decrease in incidence, the overall burden of stomach cancer in China will remain significantly higher than the global average. The burden of stomach cancer in China will be a major public health challenge, given the country's large population base and aging population.
为研究控制胃癌的相应策略，需要对疾病负担进行全面评估。在此，我们呈现中国过去三十年胃癌负担的长期趋势及其流行病学特征。
我们采用全球疾病负担研究（GBD）2021的方法和结果，根据患病率、发病率、死亡率、寿命损失年数（YLLs）、带病生存年数（YLDs）以及使用DisMod-MR 2-1估算的伤残调整生命年（DALYs）来描述中国的胃癌负担。我们还使用连接点分析和年龄-时期-队列（APC）分析方法来解读胃癌的流行病学特征，预测中国未来十年的胃癌疾病负担，并将这些趋势与全球患病率模式进行比较。
1990年至2021年期间，中国男女的年龄标准化发病率（ASIR）和死亡率（ASMR）分别从每10万人48.03（40.21，56.69）降至29.05（22.42，36.2），以及从每10万人46.05（38.88，54.43）降至21.51（16.66，26.61）。中国的年龄标准化DALY率从1990年的每10万人1181.61（978.38，1390.89）降至2021年的每10万人501.26（387.29，627.98）。中国胃癌的年龄标准化发病率、患病率和死亡率的年均变化百分比（AAPC）分别为-1.61（95%CI：-1.73，-1.48）、-0.50（95%CI：-0.67，-0.32）和-2.44（95%CI：-2.62，-2.26）。年龄、时期和队列对死亡率的影响有所不同。
在未来十年，中国胃癌的ASIR和ASMR将继续下降。然而，尽管发病率有所下降，但鉴于中国庞大的人口基数和老龄化人口，中国胃癌的总体负担仍将显著高于全球平均水平。中国的胃癌负担将是一项重大的公共卫生挑战。
