Global burden of disease for gastric cancer from 1990 to 2023 and projections of the burden to 2035

Gastric cancer (GC) remains a major global health challenge, contributing substantially to cancer incidence and mortality worldwide. This study aimed to evaluate the worldwide disease burden and evolving trends of GC utilizing the Global Burden of Disease 2023 database, intending to offer a robust scientific foundation for public health policy. Utilizing pertinent information from the Global Burden of Disease 2023 database, we calculated the estimated annual percentage change to measure temporal trends. We applied age-period-cohort models to analyze the impacts of time periods and cohorts from 1990 to 2023. Additionally, we explored the correlation between the burden of GC and the socio-demographic index through frontier analysis and health inequality evaluation while forecasting future trends utilizing Bayesian age-period-cohort models. From 1990 to 2023, the global cases of GC rose by 20.04%, reaching 1262,000; the total number of deaths increased from 912,483 to 934,795; however, cancer-related disability-adjusted life years (DALYs) declined by 8.85% compared to 1990. The age-standardized incidence rate, age-standardized mortality rate, and age-standardized DALY rate of GC have generally demonstrated a downward trend since 1990. The disease burden is notably greater in males than in females. Bayesian age-period-cohort projections indicate that by 2035, GC incidence is anticipated to reach 1,159,745, while the expected numbers of deaths and DALYs are forecasted to decline to 667,145 and 15,783,072, respectively; additionally, the impact of GC in older age demographics is projected to increase significantly. Although the age-standardized incidence, mortality, and disability rates of GC have declined globally from 1990 to 2023, the absolute number of incident cases, deaths, and DALYs remains substantial, indicating a persistent global health burden. Future prevention strategies should consider differences in demographic structure, socioeconomic development, and regional disease patterns.