Global Gastric Cancer Burden Declines, but Disparities Persist

New study finds smoking and high-salt diets as leading modifiable risk factors for early-onset gastric cancer

Published on Feb. 24, 2026

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A comprehensive global analysis of early-onset gastric cancer (EOGC) from 1990 to 2021 has revealed that while the overall burden of the disease has decreased, regional, gender, and socioeconomic disparities remain pronounced. The study, published in Cancer Biology & Medicine, identified smoking and high-salt dietary intake as the leading modifiable risk factors, accounting for over 7% of disability-adjusted life years (DALYs) worldwide. Despite public health interventions lowering incidence and mortality, EOGC continues to disproportionately affect young adults in low- and middle-income regions, emphasizing the need for tailored prevention strategies integrating smoking cessation, salt reduction, and improved access to early screening and treatment.

Why it matters

Gastric cancer remains a significant global health challenge, ranking as the fifth leading cause of cancer-related deaths worldwide. While the overall incidence has declined, early-onset cases diagnosed before age 50 display unique biological and clinical patterns, including diffuse histologic features, signet ring cell predominance, and poor prognosis. This study provides the first comprehensive global analysis of EOGC, highlighting the persistent disparities and the need for region-specific prevention strategies to address this public health issue.

The details

The research team from Chongqing Medical University, China, analyzed 371 diseases across 204 countries to assess the global burden of EOGC using Bayesian age–period–cohort modeling and joinpoint regression. In 2021, approximately 125,000 new EOGC cases, 78,000 deaths, and 3.86 million DALYs were recorded worldwide. The incidence peaked in individuals aged 45–49 years, with males showing higher prevalence, while females under 30 exhibited greater mortality risk. The age-standardized incidence and mortality rates both declined globally between 1990 and 2021, especially in East Asia and Europe, but several sub-Saharan African countries experienced rising rates.

  • The study analyzed data from 1990 to 2021 and projected trends to 2040.

The players

Chongqing Medical University

A research institution in China that conducted the comprehensive global analysis of early-onset gastric cancer.

Wei Wang

The corresponding author of the study and a researcher at Chongqing Medical University.

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What they’re saying

“EOGC poses a complex challenge because it affects individuals during their most productive years. Our findings show that preventive measures such as smoking control, salt reduction, and H. pylori eradication can significantly lower the disease burden. However, these strategies must be tailored to local conditions. In low-resource settings, strengthening healthcare infrastructure and expanding screening access are critical steps toward reducing disparities.”

— Wei Wang, Researcher, Chongqing Medical University (Cancer Biology & Medicine)

What’s next

The study underscores the importance of integrating lifestyle modification, early detection, and public health policy to address EOGC globally. High-risk regions such as East Asia should promote dietary interventions and early endoscopic screening, while low-income areas require investment in healthcare systems and public awareness programs. Tobacco taxation, food labeling, and salt reduction campaigns could further reduce exposure to key risk factors. Future research combining epidemiological data with genomic and environmental monitoring will help identify susceptible populations and optimize precision prevention strategies against EOGC.

The takeaway

This comprehensive global analysis of early-onset gastric cancer highlights the persistent disparities in incidence and mortality, particularly affecting young adults in low- and middle-income regions. The findings emphasize the need for tailored prevention strategies that address modifiable risk factors, such as smoking and high-salt diets, while also strengthening healthcare infrastructure and expanding access to early screening and treatment in underserved areas.