Recently, Lancet Gastroenterol Hepatol reported an analysis research “The global, regional, and national burden of stomach cancer in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease study 2017”. It analyzed the morbidity and mortality and DALY of gastric cancer in 21 districts and 195 countries from 1990 to 2017.
The Morbidity and mortality keep rising in many areas.
In East Asia, China ranks in the front of the list. However, there has been a steady decline in morbidity and mortality by age in recent years.In 2017, the highest incidence of age-standardized rate occurred in the high-income Asia-Pacific region, particularly in Japan, South Korea, and East Asia. It is worth mentioning that the new cases number in China accounted for half of the total cases in East Asia in 2017.
After the Asia-Pacific region, the East Europe and Latin America rank the second-highest age-standardized rate in gastric cancer, while Africa and high-income North America rank the lowest.In 2017, East Asia remained the highest in age-standardized death rate , followed by Latin America and central Asia.
East Asis has become the focus of cases rise of gastric cancer.
The high-income Asia-pacific region ranks first in age-standardized morbidity, and it ranks fourth in age-standardized mortality, and sixth in DALY. Mongolia and Afghanistan have the highest age-standardized morbidity and mortality, while high-income North America and Oceania have the lowest age-standardized morbidity and mortality.
The absolute number of death cases caused by gastric cancer caused by cause A and B occurred in 21 GBD regions from 1990 to 2017
Factors leading to castric cancer
Based on the long-term trend in the incidence of gastric cancer, environmental and lifestyle factors play important roles in the pathogenesis of gastric cancer, especially the high-sodium diet and smoking are two major risk factors.
Reducing high-salt food in the diet is one of the solutions of gastric cancer in high-risk Asian countries.
In addition, helicobacter pylori infection is also one of the most important risk factors for gastric cancer, so most prevention strategies for gastric cancer focus on the infection prevention and control of this bacterium. The report also suggests that eradication of helicobacter pylori infection on large scale is closely related to the reduction of gastric cancer.
China's cancer registry and study shows that the difference in cancer mortality is much larger than the difference in cancer incidence comparing rural and urban areas. According to the authors, this difference is due to limited medical resources, low level of cancer care, and higher rates of late-stage diagnosis in rural areas. Measures have been taken to reduce the gap in cancer care between urban and rural areas in China.
The study suggests that specific local strategies are required to further reduce the incidence and death rate of gastric cancer, in addition to overall improvements in socioeconomic status, population health, and helicobacter pylori infection rates. And risk factors should be adjusted based on the situation of each country. Early detection of suspicious cases and improved treatment facilities are effective methods to prevent gastric cancer.