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.
