Epidemiology and Disparities in Gastric Cancer Outcomes

Gastric cancer remains a leading cause of cancer-related mortality worldwide, with more than one million new cases diagnosed annually. Incidence rates have declined markedly in regions with effective Helicobacter pylori eradication and endoscopic screening programmes, yet the burden persists in East Asia, parts of Latin America and among marginalised communities in high-income countries. Epidemiological trends reveal that age-standardised mortality rates are influenced by a complex interplay of infection prevalence, dietary factors, genetic susceptibility and access to early detection. Disparities in outcomes emerge along socioeconomic, racial and geographic lines: lower income, limited health insurance coverage and residence in rural or underserved areas are consistently associated with later stage at diagnosis and poorer survival. Addressing these inequities requires integration of population-based screening, tailored prevention strategies and equitable distribution of therapeutic advances such as targeted agents and immunotherapy.

Research from Nature Portfolio

Socioeconomic disparities in the genomic landscape of gastric adenocarcinoma have been characterised in a prospective study of Peruvian patients. Tumours from lower socioeconomic groups exhibited distinct frequencies of key alterations, including increased rates of TP53 and KRAS mutations and enrichment of SOX9 variants, suggesting differential exposure to environmental carcinogens and varying needs for precision therapies. This work underscores the importance of integrating social determinants into molecular profiling to guide equitable implementation of targeted and immunotherapeutic approaches.

An analysis of occupation and industry-specific mortality among working-aged Japanese men has revealed substantial variation in gastric cancer risk. Men employed in agriculture, mining and the service sector, as well as those unemployed, experienced significantly higher gastric cancer mortality than those in manufacturing. These findings position occupation as a critical social determinant, pointing to the need for workplace-based prevention initiatives and targeted health surveillance in high-risk industries.

Epidemiology and Disparities in Gastric Cancer Outcomes publication trend

The graph below shows the total number of articles in epidemiology and disparities in gastric cancer outcomes across all publications each year (not limited to Nature Index journals).

Technical terms

Age-standardised mortality rate: Mortality rate adjusted to a standard age distribution to enable valid comparisons across populations with different age structures.

Socioeconomic status (SES): Composite measure of an individual’s or group’s economic and social position relative to others, based on income, education and occupation.

Targeted therapy: Cancer treatment using agents that specifically inhibit molecular alterations driving tumour growth.

Small area estimation: Statistical techniques used to generate reliable health estimates for small geographic regions or subpopulations where direct survey data are sparse.

References

1. The burden of stomach cancer mortality by county, race, and ethnicity in the USA, 2000–2019: a systematic analysis of health disparities. The Lancet Regional Health - Americas (2023).
2. Socioeconomic disparities and the genomic landscape of gastric cancer. Scientific Reports (2024).
3. Social determinants of health and upper gastrointestinal cancer outcomes in the United States: a systematic review. Frontiers in Public Health (2024).
4. Lung, gastric and colorectal cancer mortality by occupation and industry among working-aged men in Japan. Scientific Reports (2017).
5. Racial/ethnic disparities in gastric cancer: A 15‐year population‐based analysis. Cancer Medicine (2022).