National trends in incidence of gastric cancer among older adults (70+) from 1990 to 2021 across 204 nations: A global burden of disease study.

Abstract

e16080 Background: Gastric cancer presents global health challenges, with notable disparities in incidence and prevalence rates. This study examines trends in gastric cancer from 1990 to 2021, highlighting the evolving disease burden globally. Methods: Data from the Global Burden of Disease (GBD) for 2021 were analyzed to evaluate global incidence and prevalence rates per 100,000 individuals aged 70 years and older. Trends from 1990 to 2021 were assessed using the Annual Average Percentage Change (AAPC), with statistical significance determined by p-values. Results: In 2021, there were about 571,504 new gastric cancer cases reported globally. From 1990 to 2021, the Incidence Average Annual Percentage Change (I-AAPC) declined by -1.24 (95% CI -1.27 to -1.21, p-value < 0.00001) among individuals aged 70 and older, with negative changes observed in the 70-74 (-1.5), 75-79 (-1.4), 80-84 (-1.1), 85-89 (-0.7), and 90-94 (-0.4) age groups, with p-value < 0.00001. Conversely, the 95+ age group saw a rise in I-AAPC of 0.06. In 1990, the highest incidence rate was in those aged 85-89 at 202.2 per 100,000, while by 2021, the 90-94 age group had the highest rate at 174.9, followed by 85-89 at 164.1, and 95+ at 159.7. The lowest rate was consistently in the 70-74 age group, which was 151.3 in 1990 and 93.3 in 2021. In 2021, around 885,537 individuals globally were diagnosed with gastric cancer. From 1990 to 2021, there was a notable decline in the Prevalence Average Annual Percentage Change (P-AAPC) of -0.67 (95% CI -0.71 to -0.64), p-value < 0.01 among those aged 70 and older. Specifically, the P-AAPC was -0.80 for ages 70-74, -0.77 for 75-79, and -0.43 for 80-84, with all having a significant p-value. The 85-89 age group showed minimal change at -0.0027, while the 90-94 age group increased to 0.37, and those 95 and older to 0.19, all with significant p-values. In 1990, the highest prevalence rate was among those aged 75-79 at 233.4 per 100,000. By 2021, the highest rate shifted to the 80-84 age group at 188.4, with other rates being 185.4 for 85-89, 183.2 for 75-79, 174.7 for 70-74, and 166.8 for 90-94. The lowest was 84.7 for those 95 and older. Conclusions: In conclusion, from 1990 to 2021, gastric cancer incidence rates have declined among individuals aged 70 and older, particularly those aged 85-94. However, rates are rising for those aged 95 and older, reflecting challenges posed by an aging population. These findings underscore the importance of continued monitoring and research for public health strategies targeting older demographics. YEAR RATE OF: AAPC (95% CI), p-value < 0.000001 Prevalencen (95% CI) 1990 220.3 (204.0 to 237.2) 1990-2021: -0.67 (-0.64 to -0.71) 2000 210.8 (190.7 to 223.7) 2010 202.9 (177.1 to 217.6) 2021 179.1 (154.5 to 201.9) Incidencen (95% CI) 1990 170.3 (156.4 to 186.9) 1990-2021: -1.24 (-1.21 to -1.27) 2000 151.7 (135.1 to 162.9) 2010 136.8 (118.0 to 147.4) 2021 115.6 (99.3 to 130.5)