基于GBD 2023的中国胃癌疾病负担演变及未来趋势分析OA

Background and Aims:Gastric cancer remains an important contributor to the cancer burden in China.However,under the combined influences of population aging,changes in risk-factor exposure,and improvements in diagnosis and treatment,its disease burden characteristics have undergone substantial changes.This study aimed to systematically analyze the trends in incidence,mortality,and disability-adjusted life years(DALYs)of gastric cancer in China from 1990 to 2023,explore sex-and age-specific differences,and predict future disease burden trends bese on Global Burden of Disease Study 2023(GBD 2023)to provide evidence for precision prevention and control strategies. Methods:Data on incidence,mortality,and DALYs of gastric cancer in China from 1990 to 2023 were extracted from the(GBD 2023).Age-standardized incidence rate(ASIR),age-standardized mortality rate(ASMR),and age-standardized DALY rate(ASDR)were calculated,and temporal trends were evaluated using estimated annual percentage change(EAPC).Das Gupta decomposition analysis was performed to assess the contributions of population growth,population aging,and epidemiological changes to variations in disease burden.Bayesian age-period-cohort(BAPC)models were constructed to predict future trends in gastric cancer burden in China from 2024 to 2040. Results:From 1990 to 2023,the number of incident gastric cancer cases in China increased from 473 430 to 575 712,whereas the ASIR decreased from 54.23/100 000 to 25.04/100 000,with an EAPC of-2.76%.During the same period,the number of deaths decreased from 428 073 to 381 500,and the ASMR declined from 50.93/100 000 to 16.62/100 000,with an EAPC of-3.84%.DALYs decreased from 12.14 million to 8.91 million,while the ASDR declined from 1 314.69/100 000 to 390.14/100 000,with an EAPC of-4.17%.Males consistently exhibited higher ASIR,ASMR,and ASDR than females,and the disease burden was mainly concentrated in individuals aged 55-79 years.Decomposition analysis showed that population aging was the major driver of the increasing incidence burden,whereas epidemiological changes mainly contributed to the reductions in mortality burden and DALYs.BAPC projections indicated that the ASIR of gastric cancer in China may slightly rebound by 2040,with males continuing to bear a substantially higher burden than females,while ASMR and ASDR among females may show an upward trend. Conclusion:Although the age-standardized burden of gastric cancer in China has generally declined over the past three decades,population aging has led to a continuous increase in the absolute number of cases,accompanied by marked sex-and age-related heterogeneity.Gastric cancer prevention and control in China still face considerable challenges.Future strategies should further strengthen precision screening and comprehensive interventions based on sex,age,and high-risk populations to continuously reduce the burden of gastric cancer.