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.
