Global and regional gastric cancer burden and age-related survival disparities: complementary analyses of GBD 2021 and SEER data
4 affiliations
- 1Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University
- 2Faculty of Life Science and Technology, Kunming University of Science and Technology
- 3Pediatrics Program, 2023 Cohort, The First Clinical Medical College, Kunming Medical University
- 4Peking University Cancer Hospital Department of Gynecologic Oncology, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University
Abstract
Background: Global gastric cancer burden and patient-level survival disparities are often examined separately. This separation limits understanding of how population-level age patterns relate to clinical presentation and prognosis. We used GBD 2021 and SEER as complementary evidence sources to evaluate global and regional burden and age-related survival disparities in gastric cancer.
Methods: GBD 2021 estimates assessed incidence, deaths, and DALYs during 1990–2021 at Global, five SDI groups, and GBD-region levels. Numbers, age-standardized rates, 95% uncertainty intervals (UIs), and estimated annual percentage changes (EAPCs) were reported. An adenocarcinoma-focused SEER cohort diagnosed in 2000–2021 was evaluated across AYA (15–39 years), middle-aged (40–64 years), and older (>=65 years) groups using overall survival (OS), conventional cancer-specific survival, cumulative-incidence functions (CIFs), Gray tests, and cause-specific Cox models.
Results: Global incident cases increased from 980,899 (95% UI 891,307-1,072,236) in 1990 to 1,230,233 (1,052,350-1,409,970) in 2021, whereas the age-standardized incidence rate declined from 24.76 to 14.33 per 100,000. The SEER cohort included 89,798 patients; OS and cause-specific cohorts included 89,622 and 88,109 patients. Compared with AYA, follow-up-averaged primary Model 2 associations for older adults were HR 1.73 (95% CI 1.66-1.79) for all-cause death and 1.52 (1.46-1.58) for gastric-cancer death. CIFs showed greater non-cancer mortality among older adults.
Conclusions: Gastric cancer remains a substantial population burden despite declining age-standardized rates. Complementary population-level and U.S. patient-level evidence indicates age-related heterogeneity in burden, clinical presentation, competing mortality, and survival associations. These observations support population-level burden reduction alongside age-aware clinical management.
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BibTeX
@article{cheng2026global,
title = {{Global and regional gastric cancer burden and age-related survival disparities: complementary analyses of GBD 2021 and SEER data}},
author = {Jie Cheng and Ruitong Sun and Yun Gong and Die Fan and Lixing Wang},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1880227},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1880227/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Global and regional gastric cancer burden and age-related survival disparities: complementary analyses of GBD 2021 and SEER data
AU - Jie Cheng
AU - Ruitong Sun
AU - Yun Gong
AU - Die Fan
AU - Lixing Wang
PY - 2026
DA - 2026/10/20
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1880227
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1880227/full
AB - Background: Global gastric cancer burden and patient-level survival disparities are often examined separately. This separation limits understanding of how population-level age patterns relate to clinical presentation and prognosis. We used GBD 2021 and SEER as complementary evidence sources to evaluate global and regional burden and age-related survival disparities in gastric cancer. Methods: GBD 2021 estimates assessed incidence, deaths, and DALYs during 1990–2021 at Global, five SDI groups, and GBD-region levels. Numbers, age-standardized rates, 95% uncertainty intervals (UIs), and estimated annual percentage changes (EAPCs) were reported. An adenocarcinoma-focused SEER cohort diagnosed in 2000–2021 was evaluated across AYA (15–39 years), middle-aged (40–64 years), and older (>=65 years) groups using overall survival (OS), conventional cancer-specific survival, cumulative-incidence functions (CIFs), Gray tests, and cause-specific Cox models. Results: Global incident cases increased from 980,899 (95% UI 891,307-1,072,236) in 1990 to 1,230,233 (1,052,350-1,409,970) in 2021, whereas the age-standardized incidence rate declined from 24.76 to 14.33 per 100,000. The SEER cohort included 89,798 patients; OS and cause-specific cohorts included 89,622 and 88,109 patients. Compared with AYA, follow-up-averaged primary Model 2 associations for older adults were HR 1.73 (95% CI 1.66-1.79) for all-cause death and 1.52 (1.46-1.58) for gastric-cancer death. CIFs showed greater non-cancer mortality among older adults. Conclusions: Gastric cancer remains a substantial population burden despite declining age-standardized rates. Complementary population-level and U.S. patient-level evidence indicates age-related heterogeneity in burden, clinical presentation, competing mortality, and survival associations. These observations support population-level burden reduction alongside age-aware clinical management.
SN - 2234-943X
ER -