Gastric Cancer Incidence and Mortality Trends

Gastric cancer remains a major global health challenge, ranking among the leading causes of cancer-related death despite sustained declines in many regions. Worldwide incidence and mortality have fallen over recent decades through improved sanitation, reduced prevalence of Helicobacter pylori infection and anti-tobacco measures. Yet substantial geographic and demographic disparities persist. Some high-burden regions report a plateau or even reversal of long-term declines, driven by socioeconomic inequities, environmental exposures and shifts in dietary habits. Histological subtypes of gastric adenocarcinoma—intestinal and diffuse—exhibit distinct temporal patterns and risk profiles, with the diffuse form often affecting younger patients and associated with inherited predisposition and unique environmental interactions. The uneven progress underscores the need for tailored public health strategies, from screening and early detection in high-incidence areas to targeted prevention of key risk factors and the development of molecularly informed therapies. Integration of epidemiological surveillance with molecular characterisation offers a path to refine intervention and reduce the persistent global burden of gastric cancer.

Research from Nature Portfolio

Recent studies have illuminated how gene–environment interactions modulate gastric cancer risk in endemic regions. Work conducted in a rural Central American population has shown that prolonged wood-cookstove use markedly amplifies gastric adenocarcinoma incidence when combined with infection by a high-risk Helicobacter pylori CagA strain. Key variants in the CYP1B1 metabolising gene further modify individual susceptibility by altering internal doses of carcinogenic compounds generated during biomass combustion. This research emphasises the need to address both environmental sources of carcinogens and host genetic predisposition when designing prevention programmes in high-incidence settings.

Gastric Cancer Incidence and Mortality Trends publication trend

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

Technical terms

Age-standardised rate: A rate of disease adjusted to a standard age distribution to allow comparison between populations with differing age structures.

Joinpoint regression: A statistical method that detects points in time where a trend in incidence or mortality changes significantly.

Hotspot analysis: A geospatial technique used to identify clusters of unusually high disease incidence within a defined area.

Gene–environment interaction: The phenomenon whereby genetic susceptibility and external exposures jointly influence disease risk.

Microsatellite instability (MSI): A molecular signature of defects in DNA mismatch repair, leading to variations in short repetitive DNA sequences and associated with certain gastric cancers.

Tumour mutational burden (TMB): The number of mutations per coding area of a tumour genome, used as a biomarker to predict response to immunotherapy.

References

1. Wood cookstove use is associated with gastric cancer in Central America and mediated by host genetics. Scientific Reports (2023).
2. Stagnation in Decreasing Gastric Cancer Incidence and Mortality in Quito: Time Trend Analysis, 1985–2013. Journal of Cancer Epidemiology (2019).
3. Geospatial analyses identify regional hot spots of diffuse gastric cancer in rural Central America. BMC Cancer (2019).