Zhan Zhouwei, Chen Bijuan, Zeng Yi, Huang Rui, Yu Jiami, Guo Zengqing, Lin Xiaoyan
Department of Medical Oncology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China.
Department of Medical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian 350014, China.
PLoS One. 2025 Apr 8;20(4):e0320751. doi: 10.1371/journal.pone.0320751. eCollection 2025.
Stomach cancer continues to be a major public health concern in China, with its incidence, prevalence, mortality, and overall burden showing notable changes over time. This study set out to analyze the long-term trends of stomach cancer from 1990 to 2021, figure out the effects of aging, epidemiological changes, and population growth, and also make projections for the future. To conduct the study, data from the Global Burden of Disease Study 2021 was used. This data allowed for the analysis of various aspects such as age-standardized incidence, prevalence, mortality rates, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) related to stomach cancer in China. Joinpoint regression analysis was carried out to spot significant trends and turning points. Decomposition analysis was done to assess how much aging, epidemiological changes, and population growth contributed. Additionally, the Bayesian age-period-cohort (BAPC) model was employed to predict what the trends might be from 2021 to 2030. In 2021, there were 611,799 new cases of stomach cancer in China. The age-standardized incidence rate was 29.05 per 100,000 people, with males having a much higher rate of 44.48 compared to females at 15.23. The age-standardized prevalence and mortality rates were 57.22 and 21.51 per 100,000 respectively, and both were higher in males as well. There were also significant gender differences in DALYs, YLDs, and YLLs, with males shouldering a greater burden. From 1990 to 2021, the incidence and mortality rates went down, especially after 2004. Through decomposition analysis, it was found that aging led to a decrease in incidence but an increase in mortality, especially among males. Epidemiological changes caused both the incidence and mortality rates to drop, and the effect was more pronounced in males. The BAPC model forecasts that the incidence and mortality rates will continue to decline for both genders from 2021 to 2030, with a more rapid decrease in males. Overall, this study emphasizes the changing trends of the stomach cancer burden in China, the significant gender differences, and the impacts of aging, epidemiological changes, and population growth. It's crucial to keep monitoring and implement targeted public health strategies to further reduce the burden of stomach cancer.
胃癌在中国仍然是一个重大的公共卫生问题，其发病率、患病率、死亡率和总体负担随时间呈现出显著变化。本研究旨在分析1990年至2021年胃癌的长期趋势，找出老龄化、流行病学变化和人口增长的影响，并对未来进行预测。为开展该研究，使用了《2021年全球疾病负担研究》的数据。这些数据可用于分析中国与胃癌相关的各个方面，如年龄标准化发病率、患病率、死亡率、伤残调整生命年（DALYs）、带病生存年数（YLDs）和寿命损失年数（YLLs）。进行了Joinpoint回归分析以发现显著趋势和转折点。开展了分解分析以评估老龄化、流行病学变化和人口增长的贡献程度。此外，采用了贝叶斯年龄-时期-队列（BAPC）模型来预测2021年至2030年可能的趋势。2021年，中国有611,799例新发胃癌病例。年龄标准化发病率为每10万人29.05例，男性发病率远高于女性，男性为44.48例，女性为15.23例。年龄标准化患病率和死亡率分别为每10万人57.22例和21.51例，男性也更高。在DALYs、YLDs和YLLs方面也存在显著的性别差异，男性承担着更大的负担。从1990年到2021年，发病率和死亡率下降，特别是在2004年之后。通过分解分析发现，老龄化导致发病率下降但死亡率上升，尤其是在男性中。流行病学变化导致发病率和死亡率均下降，且对男性的影响更为明显。BAPC模型预测，从2021年到2030年，男性和女性的发病率和死亡率都将继续下降，男性下降速度更快。总体而言，本研究强调了中国胃癌负担的变化趋势、显著的性别差异以及老龄化、流行病学变化和人口增长的影响。持续监测并实施有针对性的公共卫生策略以进一步减轻胃癌负担至关重要。
