Yang Peipei, Huang Wenjie, Xu Yuanyuan, Teng Yuhao, Shu Peng
Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
School of No. 1 Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
Int J Surg. 2025 May 12. doi: 10.1097/JS9.0000000000002464.
This study aims to comprehensively compare and analyze the burden of gastric cancer and attributable risk factors in China and Group of Twenty (G20) countries from 1990 to 2021, based on the latest the Global Burden of Disease (GBD) 2021 study. It also predicts the trends in gastric cancer incidence, mortality, and disability-adjusted life years (DALYs) in China and G20 countries over the next 19 years.
This observational longitudinal study utilizes data from the GBD 2021 study, employing indicators that include incidence, mortality, DALYs, age-standardized rates, and attributable risk factors to assess gastric cancer trends. The joinpoint regression model was used to calculate the annual average percentage change to determine long-term trends of significant changes in gastric cancer occurrence in China and G20 countries. The autoregressive integrated moving average model was employed to predict the burden trends of gastric cancer in China and G20 countries from 2021 to 2040.
In 2021, the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) (95% uncertainty interval) for gastric cancer in China were 29.053 (22.423-36.2), 21.509 (16.663-26.611), and 501.26 (387.291-627.976) respectively, indicating a decrease compared to 1990. The ASIR, ASMR, and ASDR for G20 countries in 1990 and 2021 were substantially lower than those of China during the same periods. Joinpoint regression analysis demonstrated a significant overall decline in the APC of gastric cancer in China and G20 countries from 1990 to 2021, although a short-term upward trend was observed in China from 1998 to 2004. Predictions indicate a downward trend in ASIR, ASMR, and ASDR for both China and G20 countries over the next 19 years. However, in terms of risk factors, the proportion of DALYs due to smoking and high sodium diets in China ranked first among G20 countries in 2021.
Due to the implementation of preventive strategies, advancements in healthcare, and improved economic conditions, the incidence, mortality, and DALYs of gastric cancer in China have decreased. However, there remains a certain gap compared to G20 countries at the same time. In the future, China should develop more detailed prevention and control strategies targeting risk factors, tailored to men, women, and different age groups.
本研究旨在基于最新的《2021年全球疾病负担研究》，全面比较和分析1990年至2021年中国与二十国集团（G20）国家胃癌负担及可归因风险因素。同时预测未来19年中国和G20国家胃癌发病率、死亡率及伤残调整生命年（DALYs）的趋势。
本观察性纵向研究利用《2021年全球疾病负担研究》的数据，采用发病率、死亡率、DALYs、年龄标准化率和可归因风险因素等指标评估胃癌趋势。采用Joinpoint回归模型计算年度平均百分比变化，以确定中国和G20国家胃癌发病显著变化的长期趋势。运用自回归积分滑动平均模型预测2021年至2040年中国和G20国家胃癌负担趋势。
2021年，中国胃癌的年龄标准化发病率（ASIR）、年龄标准化死亡率（ASMR）和年龄标准化DALYs率（ASDR）（95%不确定区间）分别为29.053（22.423 - 36.2）、21.509（16.663 - 26.611）和501.26（387.291 - 627.976），与1990年相比呈下降趋势。1990年和2021年G20国家的ASIR、ASMR和ASDR均显著低于同期中国。Joinpoint回归分析表明，1990年至2021年中国和G20国家胃癌的APC总体呈显著下降趋势，不过中国在1998年至2004年期间出现了短期上升趋势。预测显示，未来19年中国和G20国家的ASIR、ASMR和ASDR均呈下降趋势。然而，在风险因素方面，2021年中国因吸烟和高钠饮食导致的DALYs比例在G20国家中排名第一。
由于预防策略的实施、医疗保健的进步以及经济条件的改善，中国胃癌的发病率、死亡率和DALYs有所下降。然而，与同期G20国家相比仍存在一定差距。未来，中国应针对男性、女性和不同年龄组，制定更详细的针对风险因素的防控策略。
