Global analysis finds widening disparities in early-onset gastric cancer
A global analysis of early-onset gastric cancer found mortality declining 2.9% annually from 1990 to 2021, while disparities between high- and low-income regions widened. In 2021, the disease accounted for about 125,000 new cases, 78,000 deaths, and 3.86 million DALYs worldwide.
Early-onset gastric cancer cases diagnosed before age 50 continue to show widening inequalities between high- and low-income regions despite an overall global decline in mortality. A comprehensive global analysis of early-onset gastric cancer from 1990 to 2021 using Global Burden of Disease 2021 data found a 2.9% annual decline in global mortality, but said inequalities between high- and low-income regions are widening.
In 2021, approximately 125,000 new early-onset gastric cancer cases, 78,000 deaths, and 3.86 million disability-adjusted life years were recorded worldwide. The incidence peaked in individuals aged 45–49 years, with males showing higher prevalence, while females under 30 exhibited greater mortality risk.
The age-standardized incidence and mortality rates both declined globally between 1990 and 2021, especially in East Asia and Europe. However, several sub-Saharan African countries experienced rising rates.
Smoking and high-salt diets were identified as the main risk factors, accounting for 7.1% and 7.7% of disability-adjusted life years, respectively. Smoking accounted for more than 10% of DALYs in East Asia and Central Europe, while high-salt diets showed consistent impact worldwide.
The study said disparities were strongly linked to socioeconomic development: high-income regions achieved steady reductions through screening and health education, while low-income regions faced growing burdens due to limited healthcare access and population growth. Projections suggest a continued global decline through 2040, yet with persistent disparities.
The analysis used Bayesian age–period–cohort modeling and joinpoint regression to assess the global burden of early-onset gastric cancer across 204 countries. The findings were published in Cancer Biology & Medicine.