ObjectiveTo analyze the incidence trend and characteristics of gastric cancer in China from 1990 to 2023, and to provide a basis for prevention and control efforts. MethodsBased on the relevant data from the Global Burden of Disease 2023 Database, Joinpoint regression analysis was used to calculate the average annual percent change (AAPC) of the age-standardized incidence rate (ASIR) of gastric cancer; the age-period-cohort model was adopted to analyze the longitudinal age curve of gastric cancer incidence and the period/cohort rate ratio (RR), and to explore the variation in incidence risk with age, period, and cohort. ResultsFrom 1990 to 2023, the national ASIR of gastric cancer decreased from 54.23 per 100 000 to 25.04 per 100 000, with an AAPC of –2.19% (t=–9.21, P<0.001). For males, it decreased from 72.74 per 100 000 to 37.90 per 100 000, with an AAPC of –1.85% (t=–5.85, P<0.001); for females, it decreased from 36.92 per 100 000 in 1990 to 12.93 per 100 000, with an AAPC of –3.07% (t=–22.55, P<0.001). The results of age-period-cohort analysis showed that the risk of gastric cancer in Chinese residents first increased and then decreased with age, and the ASIR of the total population peaked at 143.74 per 100 000 in the 75–79 age group [95%CI (137.30 per 100 000, 150.48 per 100 000)]. After adjusting for age and cohort effects, the risk of gastric cancer in Chinese residents showed a downward trend between 1990 and 2023. Taking the 2005–2009 period as the reference, the risk of gastric cancer in Chinese residents was the highest in the 1990–1994 period group, which was 1.45 times that of the 2005–2009 period group [RR=1.45, 95%CI (1.39, 1.51)]. By 2020–2023, the incidence risk dropped to the lowest level during the study period, which was 0.68 times that of the 2005–2009 period group [RR=0.68, 95%CI (0.66, 0.71)]. After adjusting for age and period effects, the risk of gastric cancer in Chinese birth cohorts fluctuated slightly in the early stage, then decreased rapidly, and then increased slightly. Taking the 1955–1959 birth cohort as the reference, the risk of gastric cancer in Chinese residents born in 1900–1904 was the highest, which was 2.54 times that of the reference cohort [RR=2.54, 95%CI (1.48, 4.35)]. By 1995–1999, the incidence risk dropped to the lowest level during the study period, which was 0.29 times that of the reference cohort [RR=0.29, 95%CI (0.20, 0.41)]. Overall, the risk of gastric cancer in females was significantly lower than that in males. ConclusionsSignificant gender and age disparities exist in the risk of gastric cancer incidence in China, with males and middle-aged/older adults being high-risk groups. Age, period, and birth cohort all significantly influence the risk. It is recommended to strengthen the intervention of risk factors and expand the coverage of Helicobacter pylori infection screening and radical treatment for key groups such as males and the elderly to further reduce the risk of gastric cancer.
The May 12 8-magnitude earthquake caused damage to 87.7% of the health systems in the worst-hit Mianyang areas with 326 casualties and the direct economic loss of RMB 3 124 billion. Within 30 minutes after the earthquake, the Mianyang headquarters for earthquake disaster relief and the Mianyang public health headquarters for medical rescue and treatment were organized. Five medical teams were sent to Beichuang County, the worst-hit Mianyang area within four hours after the earthquake. A total of 22 947 wounded and sick were delivered to local hospitals after simple triage and rapid treatment through three station. By June 30, the Mianyang medical organisation had received 379 600 person times and admitted 21628 inpatients in total, including 2 772 severely-wounded (including 146 with limbs amputated and 846 dead during the stay). Since May 17, 3381 wounded had been transferred to 14 provincial and city-level hospitals across China. On June 20, the Mianyang Rehabilitation Center for wounded and sick people was established and received 156 rehabilitation inpatients and cured 32 ones. Together with the medical team for psychological intervention, they provided psychological support for victims for over 70 000 person times. Within two hours after the earthquake, the Mianyang Organisation for Health and Epidemic Control and Prevention launched the emergency response plan for major natural disasters, prepared and improved the technical scheme for disease prevention after the earthquake. The organisation rapidly sent out emergency teams for disease control and prevention and completed the following tasks: disinfection and burial of corpses and disposal of carcasses, monitoring of the water quality and epidemics, disinfection of environmental ruins, epidemic control in resettled areas, precaution of the secondary disasters caused by the earthquake and conduction of large-scale health education. The emergency command system for medical rescue and disease control and prevention in the worst-hit Mianyang areas after Wenchuan Earthquake integrated resources, carried out the unified command and responded rapidly. Moreover, the headquarter of medical relief coordinated and orderly unified the governmental and non-governmental organizations, which achieved good performance for both medical relief and anti-epidemic. The experience of earthquake medical relief will benefit the post-disaster reconstruction, as well as the establishment of national and regional emergency response systems.
