Current and future burden of gastric cancer: an analysis based on CDC WONDER and the global cancer observatory

Gastric cancer remains a major contributor to the global cancer burden, with marked geographic disparities and a substantial contribution from population ageing. We aimed to integrate recent mortality trends in the United States with the latest global burden estimates to provide an updated overview of the current and future burden of gastric cancer. Using CDC WONDER, we analyzed gastric cancer mortality among US adults aged 25 years and older from 1999 to 2024 and estimated temporal changes with Joinpoint regression. Using Global Cancer Observatory 2022 data, we described incidence, mortality, age-standardized rates, and mortality-to-incidence ratios worldwide and examined patterns by age group, region, and Human Development Index. Projected numbers of incident cases and deaths through 2045 were obtained from Cancer Tomorrow. Between 1999 and 2024, 297,532 gastric cancer deaths occurred among U.S. adults aged ≥ 25 years. The age-adjusted mortality rate (AAMR) declined from 7.16 to 4.01 per 100,000 (AAPC, − 2.43%; 95% CI, − 2.53% to − 2.33%), although mortality remained higher in men. In 2024, AAMRs were 6.47 among Hispanic individuals, 6.24 among non-Hispanic Black individuals, and 3.08 among non-Hispanic White individuals. The West had the highest regional AAMR (4.48), and state-level rates ranged from 2.38 to 6.13. Globally, 965,807 incident cases and 658,246 deaths occurred in 2022 among persons aged 25–85 + years. Eastern Asia accounted for 53.9% of cases and 48.3% of deaths; adults aged 50–85 + years accounted for 91.8% and 92.4%, respectively. Under the constant-rate scenario, absolute case and death numbers were projected to increase across most regions by 2045, with Eastern Asia remaining the largest contributor. Despite substantial declines in mortality in the United States, the global absolute burden of gastric cancer remains high and is projected to rise further. These findings highlight persistent regional inequalities and support the need for earlier detection, timely treatment, and more equitable cancer control strategies in high-burden and high-MIR settings.