JMIR Publications

ABSTRACT

Background:

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.

Objective:

Using the Global Burden of Disease Study (GBD) 2021, this research aims to estimate the burden and risk factors of GC in Eastern Asia from 1990 to 2021

Methods:

Incidence, age-standardized incidence rate (ASIR), deaths, age-standardized mortality rate (ASMR), disability-adjusted life years (DALYs), age-standardized rate of DALYs (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 (APC), while age-period-cohort analysis assessed temporal trends. The bayesian age-period-cohort (BAPC) model projected GC burden from 2021 to 2035. All analyses used R software (version 4.4.1).

Results:

In 2021, Eastern Asia reported 748,235 new GC cases and 527,054 deaths, accounting for 60.8% new cases and 55.4% deaths reported globally. From 1990 to 2021, South Korea showed the largest declines in ASIR, ASMR, and ASDR, with ASMR decreasing from 55.4/100,000 to 13.3/100,000 [AAPC, -4.5 (-4.8, -4.3)]. ASIR, ASMR and ASDR also showed a downward trend in Japan and China, with AAPC of -3.0 (95%CI, -3.2, -2.8) for ASMR in Japan and -2.4 (95%CI, -2.6, -2.3) in China. The GC burden of North Korea was basically stable, with AAPC of ASMR was -0.8 (-0.8, -0.8). Mongolia showed a slight decline, with AAPC of ASMR was -1.4 (-1.7, -1.0), and the burden of GC was the highest. High-sodium diets and smoking were the main risk factors for DALYs of GC in 2021. Smoking contributed to a decline in ASDR as the SDI increased. Projections suggest continued ASDR reductions across Eastern Asia from 2022 to 2035, though Mongolia will maintain the highest burden.

Conclusions:

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. Clinical Trial: This study uses publicly available data from the Global Burden of Disease (GBD) database. The GBD data are anonymized and aggregated at the population level, and no individual-level information is included. Ethical approval and informed consent were not required for the use of these data. Access to the GBD database complies with all applicable data use agreements and guidelines provided by the Institute for Health Metrics and Evaluation (IHME).