The Burden of Early-Onset Gastric Cancer From 1990 to 2021: A Systematic Analysis for the Global Burden of Disease Study 2021.
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BACKGROUND: Gastric cancer (GC) is a substantial global health burden, with early-onset gastric cancer (EOGC) posing distinct diagnostic and management challenges in adolescents and young adults. This study evaluated the global burden, temporal trends, and associated factors of EOGC. METHODS: Using Global Burden of Disease (GBD) 2021 data, we evaluated EOGC age-standardized incidence rates (ASIRs), age-standardized death rates (ASDRs), disability-adjusted life years (DALYs), and age-standardized DALY rates (ASRs) across 204 countries and territories from 1990 to 2021. Metrics were stratified by region, country, Socio-demographic Index (SDI), age, and gender. Trends were evaluated using Joinpoint Regression, and Bayesian Age-Period-Cohort (BAPC) models were used to generate model-based projections of incidence, mortality, and DALYs to 2035. RESULTS: From 1990 to 2021, global EOGC ASIR, ASDR, and ASR declined by an average of 2.13%, 2.80%, and 2.78% per year, respectively. Females exhibited a more pronounced decline than males, and higher-SDI regions generally experienced faster reductions than lower-SDI regions. Among the 2 risk factors with attributable estimates available in GBD 2021 for this population, smoking and a diet high in sodium contributed to EOGC mortality. Baseline model-based projections indicated a continued decrease in the global EOGC burden through 2035. CONCLUSION: Since 1990, the global ASDR, ASIR, and ASR for EOGC have consistently declined. However, substantial disparities persist across regions, countries, age groups, and genders. Tailored prevention and intervention strategies, informed by regional characteristics and risk factors, are essential to effectively reduce the global EOGC burden.