The burden of Gastric Cancer and possible risk factors from 1990 to 2021，and projections until 2035: findings from the Global Burden of Disease Study 2021

Background Gastric cancer exhibit high morbidity and mortality rate in China, resulting in substantial disease burdens. A comprehensive evaluation of the burden is crucial to improve strategies for gastric cancer prevention and treatment. Methods We collected incidence, deaths, disability-adjusted life-years (DALYs), age-standardized incidence rate(ASIR), age-standardized death rate (ASDR), age-standardized DALY rate (ASR) of gastric cancer at the global, regional, and national levels in all 204 countries and territories from 21 regions during 1990 to 2021. The Bayesian age-period-cohort model was applied to project future trends until 2035. Results In 2021, The new cases, deaths and DALYs of gastric cancer increased. More than 1.23 million incident cases of gastric cancer were reported worldwide, which caused 954373.60 deaths and 22786633.10 DAYLs. The age-standardized rates for incidence, death and DALYs decreased by-42%(-49% to -35%),-49%(-55% to -43%) and − 53%(-58% to -47%) from 1990 to 2021, respectively. The highest age-standardized incidence and death rates in 2021 were observed in the High-middle SDI quintile. Both the age-standardized death, incidence and DALYs rate among males were all higher than those among females. In 2021, East Asia and High-income North America had the highest disease burden related to smoking, and Central Europe had the highest disease burden related to diet high in sodium. Furthermore, projections suggest that the ASIR and ASDR of gastric cancer will likely follow steady downward trends by 2035. Conclusions Gastric cancer continued to cause a heavy burden globally and in different countries and regions, with significant decreased in the incidence and mortality. Death and DALY rates attributable to high sodium diet and smoking have generally declined. There are still significant differences between age groups and regions. Targeted preventive measures, such as controlling smoking and increasing intake of fresh vegetables and fruits, should be taken in the future to reduce the risk of gastric cancer