Trends and projections of the burden of gastric cancer in China and G20 countries: a comparative study based on the global burden of disease database 2021

PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.