Kong Weijia, Sun Yuting, Qin Xiaoyan, Zhu Guanghui, Zhu Xiaoyu, Kuang Ziyu, Xiao Zhigang, Li Jie
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, 5 Beixiange Street, Xicheng District, Beijing, 10053, China, +86-10-83123311.
Graduate School, Beijing University of Chinese Medicine, Beijing, China.
JMIR Cancer. 2025 Aug 8;11:e75728. doi: 10.2196/75728.
Eastern Asia has historically had the highest global incidence and mortality rates of gastric cancer (GC) while substantial disparities exist between countries. The overall burden of GC remains insufficiently explored.
Using the Global Burden of Disease Study 2021, this research aims to estimate the burden and risk factors of GC in Eastern Asia from 1990 to 2021.
Incidence, age-standardized incidence rate (ASIR), deaths, age-standardized mortality rate (ASMR), disability-adjusted life years, age-standardized disability-adjusted life year rate (ASDR), and risk factor burdens for GC were analyzed in Eastern Asia from 1990 to 2021. Joinpoint analysis determined average annual percent change (AAPC) and annual percent change, while age-period-cohort analysis assessed temporal trends. The Bayesian age-period-cohort model projected GC burden from 2021 to 2035. All analyses used R software (version 4.4.1; R Foundation for Statistical Computing).
In 2021, Eastern Asia reported 748,235 new GC cases and 527,054 deaths, accounting for 60.8% (748,235/1,230,232) of new cases and 55.2% (527,054/954,373) of deaths reported globally. From 1990 to 2021, South Korea showed the largest declines in ASIR, ASMR, and ASDR, with ASMR decreasing from 55.4 per 100,000 to 13.3 per 100,000 (AAPC -4.5, 95% CI -4.8 to -4.3). ASIR, ASMR, and ASDR also showed a downward trend in Japan and China, with an AAPC of -3.0 (95% CI -3.2 to -2.8) for ASMR in Japan and -2.4 (95% CI -2.6 to -2.3) in China. The GC burden of North Korea was basically stable, with an AAPC of ASMR of -0.8 (95% CI -0.8 to -0.8). Mongolia showed a slight decline, with an AAPC of ASMR of -1.4 (95% CI -1.7 to -1.0), and the burden of GC was the highest. High-sodium diets and smoking were the main risk factors for disability-adjusted life years of GC in 2021. Smoking contributed to a decline in ASDR as the sociodemographic index increased. Projections suggest continued ASDR reductions across Eastern Asia from 2022 to 2035, though Mongolia will maintain the highest burden.
Despite a decrease from 1990 to 2021, GC remains a significant public health issue in Eastern Asia. Addressing it necessitates prioritizing primary and secondary prevention, including reducing risk factors and enhancing early screening.
东亚地区一直以来都是全球胃癌（GC）发病率和死亡率最高的地区，且各国之间存在显著差异。胃癌的总体负担仍未得到充分研究。
利用《2021年全球疾病负担研究》，本研究旨在估计1990年至2021年东亚地区胃癌的负担及风险因素。
分析了1990年至2021年东亚地区胃癌的发病率、年龄标准化发病率（ASIR）、死亡人数、年龄标准化死亡率（ASMR）、伤残调整生命年、年龄标准化伤残调整生命年率（ASDR）以及风险因素负担。Joinpoint分析确定平均年度百分比变化（AAPC）和年度百分比变化，而年龄-时期-队列分析评估时间趋势。贝叶斯年龄-时期-队列模型预测了2021年至2035年的胃癌负担。所有分析均使用R软件（版本4.4.1；R统计计算基金会）。
2021年，东亚地区报告了748235例新胃癌病例和527054例死亡病例，分别占全球新病例的60.8%（748235/1230232）和死亡病例的55.2%（527054/954373）。1990年至2021年，韩国的ASIR、ASMR和ASDR下降幅度最大，ASMR从每10万人55.4例降至每10万人13.3例（AAPC为-4.5，95%CI为-4.8至-4.3）。日本和中国的ASIR、ASMR和ASDR也呈下降趋势，日本ASMR的AAPC为-3.0（95%CI为-3.2至-2.8），中国为-2.4（95%CI为-2.6至-2.3）。朝鲜的胃癌负担基本稳定，ASMR的AAPC为-0.8（95%CI为-0.8至-0.8）。蒙古呈轻微下降趋势，ASMR的AAPC为-1.4（95%CI为-1.7至-1.0），且胃癌负担最高。高钠饮食和吸烟是2021年胃癌伤残调整生命年的主要风险因素。随着社会人口学指数的增加，吸烟导致ASDR下降。预测表明，2022年至2035年整个东亚地区的ASDR将持续下降，不过蒙古的负担仍将最高。
尽管1990年至2021年有所下降，但胃癌在东亚地区仍然是一个重大的公共卫生问题。解决这一问题需要优先考虑一级和二级预防，包括降低风险因素和加强早期筛查。
