ObjectiveTo interpret and compare the epidemiologic data of gastric cancer incidence and mortality in the world and China during 2018–2022, and to evaluate the disease burden of gastric cancer in China. MethodBased on the GLOBOCAN 2018–2022 cancer registry data released by the International Agency for Research on Cancer (IARC), both the crude and the age-standardized incidence and mortality data of gastric cancer were retrieved, while the situation of gastric cancer incidence and mortality was compared between China and the world. ResultsComparing with the global incidence and mortality of gastric cancer, although the incidence and mortality of gastric cancer in China showed a consistently declining trend, the numbers of incident cases and deaths kept the greatest in the world, which was one of the important cancer disease burdens in China. In the 2022 report, there were 968 350 incident cases and 660 175 deaths from gastric cancer worldwide. Therein, China had the greatest number of incident cases and deaths from gastric cancer, i.e. 358 000 (37.0% of the global total) and 260 000 (39.5% of the global total), respectively. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for gastric cancer worldwide were 9.2/100 000 and 6.1/100 000, respectively; in China, the ASIR and ASMR were 13.7/100 000 and 9.4/100 000, respectively, both of which were higher than the global average levels. Similarly, in terms of the assessment on population morbidity index (PMI), the risk of death from gastric cancer in China appeared a declining trend, but it was still at a higher level compared to the global average. In very high and high human development index (HDI) countries/regions, the ASIR and ASMR of gastric cancer were higher than those in medium and low HDI countries/regions, while the trend was similar when stratified by gross national income (GNI) per capita. In countries/regions with very high HDI or high GNI per capita, the PMI was lower than those in other stratified countries/regions. There were certain geographic disparities in the ASMR of gastric cancer in China. The western region, especially the Qinghai-Tibet Plateau region, had the heaviest burden of gastric cancer deaths, and a few provinces in the central and eastern regions also faced a heavy burden of gastric cancer deaths. Similar to the global situation, the incidence and death risk of gastric cancer were higher among males in China. The ASIR and ASMR in males were more than two times to those in females, while the PMI in males and females were comparable. Globally, subpopulation ≥50 years old entered the age-groups with high incidence of gastric cancer, while in China, the high incidence age-groups were since 45 years old. ConclusionsThe burden of gastric cancer is still heavy in China and higher than the global level. HDI, GNI per capita, regional distribution, gender, and age are associated with the incidence and death risks of gastric cancer. The key points of gastric cancer prevention and control in China should be focused on raising awareness of cancer prevention among the public population, establishing tertiary prevention system in subnational areas, supporting large-scale population screening projects, systematically surveilling the high-risk subpopulation, promoting standardized cancer diagnosis and treatment, and whole-life managing and caring cancer patients.
ObjectiveTo compare the epidemiological differences of gastric cancer among the China, Japan, and South Korea in recent years, and put forward targeted questions and suggestions for further high-quality development of gastric cancer control in China. MethodsBased on the GLOBOCAN registry data of 2018, 2020, and 2022 released by the International Agency for Research on Cancer, this study systematically analyzed and evaluated the epidemiological characteristics of gastric cancer in China, Japan, and South Korea. Specifically, it compared the differences in incidence, mortality, and case-fatality risk of gastric cancer between China and the other two countries. Subgroup analyses included gender-specific and age-specific observation and comparisons. Sensitivity analyses involved consistency comparison of results derived from crude data and age-standardized data. ResultsOverall, there were still significant differences in the incidence, mortality, and case-fatality risk of gastric cancer among China, Japan, and South Korea. The absolute burden of gastric cancer incidence in China was significantly higher than that in Japan and South Korea, but the proportion of China in global new gastric cancer cases decreased from 44.1% to 37.0%, with a reduction of 7.1%. Both the crude incidence rate (from 33.1 per 100 000 persons to 25.4 per 100 000 persons) and age-standardized incidence rate (from 20.7 per 100 000 persons to 13.7 per 100 000 persons) of gastric cancer in China showed a consistent downward trend, and were significantly lower than those in Japan and South Korea. In 2022, the age-standardized incidence rates of gastric cancer were 27.6 per 100 000 persons and 27.0 per 100 000 persons in Japan and South Korea, respectively. The proportion of China in global gastric cancer deaths was heavier than that of incidence, but it also decreased from 49.9% to 39.5%, with a reduction of 10.4%. Similarly, the crude mortality rate (from 27.4 per 100 000 persons to 18.4 per 100 000 persons) and age-standardized mortality rate (from 17.5 per 100 000 persons to 9.4 per 100 000 persons) of gastric cancer in China presented a rapid downward trend. In 2022, the age-standardized mortality rates of gastric cancer were 7.2 per 100 000 persons and 6.5 per 100 000 persons in Japan and South Korea, respectively. By 2022, the crude case-fatality risk of gastric cancer in the Chinese population was still significantly higher than that in Japan [RR=1.63, 95%CI (1.04, 2.56), P=0.034] and South Korea [RR=1.86, 95%CI (1.08, 3.22), P=0.026]. In all three countries, the incidence rate, mortality rate, and case-fatality risk of gastric cancer in males were higher than those in females in each year, but the sex differences showed a narrowing trend. In 2022, the age-standardized incidence rates of gastric cancer in China, Japan, and South Korea all increased rapidly after exceeding 20 per 100 000 persons at the point of 45 years old, and the case-fatality risk also increased with age. ConclusionsAlthough the absolute disease burden of gastric cancer in China remains substantial in recent years, a significant downward trend has emerged. The crude and age-standardized incidence rate of gastric cancer in China is lower than that in Japan and South Korea, whereas the case-fatality risk of gastric cancer in China remains notably higher than that in the other two countries. It is necessary to continuously strengthen the systematic prevention and management, screening and surveillance of high-risk subpopulation, and quality control of standardized diagnosis and treatment.
Objective To investigate short-term effectiveness and clinical application advantages of orthopedic robot-assisted resection for osteoid osteoma compared with traditional open surgery. Methods A retrospective analysis was conducted on clinical data of 48 osteoid osteoma patients who met the selection criteria between July 2022 and April 2023. Among them, 23 patients underwent orthopedic robot-assisted resection (robot-assisted surgery group), and 25 patients received traditional open surgery (traditional surgery group). There was no significant difference (P>0.05) in gender, age, disease duration, lesion location and size, and preoperative visual analogue scale (VAS) score, and musculoskeletal tumor society (MSTS) score between the two groups. The surgical time, intraoperative blood loss, intraoperative lesion localization time, initial localization success rate, infection, and recurrence were recorded and compared. VAS scores before surgery and at 24 hours, 1, 3, 6, and 9 months after surgery and MSTS score before surgery and at 3 months after surgery were assessed. Results All patients completed the surgery successfully, with no significant difference in surgical time between the two groups (P>0.05). Compared to the traditional surgery group, the robot-assisted surgery group had less intraoperative blood loss, shorter lesion localization time, and shorter hospitalization time, with significant differences (P<0.05). The initial localization success rate was higher in the robot-assisted surgery group than in the traditional surgery group, but the difference between the two groups was not significant (P>0.05). All patients in both groups were followed up, with the follow-up time of 3-12 months in the robot-assisted surgery group (median, 6 months) and 3-14 months in the traditional surgery group (median, 6 months). The postoperative MSTS scores of both groups improved significantly when compared to those before surgery (P<0.05), but there was no significant difference in the changes in MSTS scores between the two groups (P>0.05). The postoperative VAS scores of both groups showed a gradually decreasing trend over time (P<0.05), but there was no significant difference between the two groups after surgery (P>0.05). During follow-up, except for 1 case of postoperative infection in the traditional surgery group, there was no infections or recurrences in other cases. There was no significant difference in the incidence of postoperative infection between the two groups (P>0.05). Conclusion Orthopedic robot-assisted osteoid osteoma resection achieves similar short-term effectiveness when compared to traditional open surgery, with shorter lesion localization time.
