Epidemiology

There are pronounced global epidemiological variations in stomach cancer. Higher incidences are reported in Eastern Asia (particularly in Korea, Mongolia, Japan, and China), Central and Eastern Europe, and South America. Lower incidence rates are reported in North America, North and Western Europe, and Africa.[4]​​

The American Cancer Society estimates that 30,300 new patients will be diagnosed with gastric cancer in the US in 2025, and that 10,780 people will die from gastric cancer in the same year.[5] Men are more likely to have gastric cancer than women.[5][6] In the US, African-American, Hispanic, and American-Indian people are twice as likely to develop stomach cancer as white people.[5]

In England and Wales over the period 1 January 2022 to 31 December 2023, 5452 people were diagnosed with gastric cancer. The median age at diagnosis was 73 years, and there was a 2:1 male to female ratio.[7]

Gastric cancer incidence and gastric cancer mortality have been declining in the US since the middle of the 20th century.[5]​​ This is believed to be attributable to the increased availability of fresh vegetables and fruits, refrigeration (reducing need for salt-preserved food), and a reduction in chronic Helicobacter pylori infection. However, first-generation immigrants from high- to low-incidence regions maintain higher risks of incidence and mortality.[6][8][9][10][11]​​​​​​​​​​

While the overall rates of stomach cancer continue to decline, adenocarcinoma of the gastric cardia is increasing in North America and Europe. This is thought to be related to increased obesity, and, perhaps, improvement in classification.​[12]

Although the overall incidence of gastric cancer is declining, there has been a notable increase in early-onset gastric cancer, defined as gastric cancer diagnosed in individuals aged <50 years.[6][13][14]​​ While gastric cancer generally shows a higher prevalence in men compared with women, the reverse is true for early-onset gastric cancer, where women are more affected.[6] Globally, in 2022, early-onset gastric cancer accounted for 23.8% of early-onset gastrointestinal cancer cases, with 80,885 reported cases.[14] In the US, early-onset gastric cancer comprises 10.5% of all gastric cancer cases.[14] Although early-onset gastric cancer was historically linked to hereditary syndromes, such as hereditary diffuse gastric cancer and Lynch syndrome, data indicate that these hereditary disorders account for only approximately 3% of cases.[6][13]

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