Trends in mortality for gastric cancer from 2011 to 2020 with prediction to 2030: a Bayesian age-period-cohort analysis

Background: Gastric cancer was the 3rd most common cause of cancer deaths, accounting for 11.3% of all cancer deaths in China in 2018. The study aims to analyze trends in gastric cancer mortality in China from 2011 to 2020, and predict the future burden of gastric cancer from 2021 to 2030. Methods: Relevant data on gastric cancer were obtained from the National Mortality Surveillance System, which is available from the Chinese Center for Disease Control and Prevention. All deaths with underlying cause of death as gastric cancer (International Classification of Diseases-10 code: C16) were included. We analyzed the numbers and age-standardized mortality rates (ASMR) for gastric cancer by sex and urbanicity in China during 2011-2020. A Bayesian age-period-cohort (BAPC) prediction model was used to predict gastric cancer mortality by sex and urbanicity in China from 2021 to 2030. The gastric cancer death data from 2011 to 2020 were categorized into five-year age groups, from 0-4 to 80+. Population data for 2011-2020 were obtained from the National Bureau of Statistics. Projected population data for 2021-2030 were based on estimates derived from 2011-2020 population. The standard population for calculating ASMR was derived from the China Census in 2020. Findings: In 2020, the ASMR for gastric cancer was 22.24/100,000, accounting for 291.20 thousand deaths in China, including 199.66 thousand males and 91.53 thousand females. The ASMR in males (32.57/100,000) was higher than that in females (13.09/100,000). From 2011 to 2020, the number of gastric cancer deaths in China showed a gradual downward trend, with a notable decline in the ASMR. From 2021 to 2030, the ASMR for gastric cancer in China is expected to continue declining. In 2030, It is anticipated that the ASMR of gastric cancer in China will be 11.68/100,000, resulting in an estimated 218.93 thousand deaths. The ASMR for males is projected to decrease to 17.78/100,000, representing a 45.4% reduction from 2020. For females, the ASMR will decrease to 6.81/100,000 corresponding to a significant reduction of 48.0% from the 2020. In 2030, the projected ASMR for gastric cancer is 11.67/100,000 in urban areas and 12.04/100,000 in rural areas, accounting for 111.90 thousand and 125.92 thousand deaths, respectively. Compared to 2020, the ASMR for gastric cancer in 2030 shows a 38.7% and 50.9% reduction in urban and rural areas, respectively. Interpretation: From 2011 to 2020, both the number of deaths and the ASMR of gastric cancer in China gradually declined. The number of gastric cancer deaths in China is projected to continue declining through 2030. The findings indicate that the preventive and control measures for gastric cancer are effective and may provide useful reference for development of preventive and control strategies for other major cancers in China.