Table 5_Temporal and spatial trends in gastric cancer burden in the USA from 1990 to 2021: findings from the global burden of disease study 2021.xlsx

BackgroundGastric cancer (GC) is a significant public health concern in the USA, and its burden is on the rise.
MethodsThis study utilized the latest data from the Global Burden of Disease (GBD) study. We provided descriptive statistics on the incidence, prevalence, mortality, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) of GC across the USA and states. By calculating percentage changes and average annual percentage changes (AAPC), along with conducting age-period-cohort analysis, we assessed the trends in the burden of GC. Decomposition analysis was then performed, followed by the application of an autoregressive integrated moving average (ARIMA) model to forecast changes in ASRs through 2036.
ResultsFrom 1990 to 2021, the number of incidence and prevalence of GC in the USA increased, but age-standardized incidence rates (ASIR) trended downward (AAPC = -0.73, 95% confidence interval [CI]: -0.77 to -0.68) and age-standardized prevalence rates (ASPR) (AAPC = -0.99, 95% CI: -1.08 to -0.9) showed a decreasing trend. In addition, the number of deaths, DALYs, age-standardized mortality rates (ASMR) and age-standardized DALYs rates (ASDR) in GC showed a decreasing trend. The burden of GC was significantly higher in males compared to females. In addition, we found that the highest incidence and prevalence in females was in the age group of 75-79 years, whereas the highest incidence and prevalence in males was in the age group of 70-74 years.
ConclusionGC is a major public health issue in the USA. Although ASIR, ASPR, ASMR, and ASDR for GC are decreasing, the number of incidence and prevalence of GC in the USA remains high, and the disease burden of GC in the USA remains high. Strengthening preventive interventions, particularly for men and patients over the age of 60, will be crucial in the future.

研究背景
胃癌（Gastric cancer, GC）是美国面临的重大公共卫生问题，且其疾病负担呈上升趋势。
研究方法
本研究采用全球疾病负担（Global Burden of Disease, GBD）研究的最新数据。针对美国全国及各州的胃癌发病情况、患病情况、死亡情况、伤残调整寿命年（Disability-Adjusted Life Years, DALYs）及年龄标准化率（Age-Standardized Rates, ASRs），本研究开展了描述性统计分析。通过计算百分比变化与年均百分比变化（Average Annual Percentage Changes, AAPC），并实施年龄-时期-队列分析，本研究评估了美国胃癌的疾病负担变化趋势。随后本研究开展了分解分析，并应用自回归积分滑动平均（Autoregressive Integrated Moving Average, ARIMA）模型，对截至2036年的年龄标准化率变化进行预测。
研究结果
1990年至2021年，美国胃癌的发病例数与患病人数均有所上升，但年龄标准化发病率（Age-Standardized Incidence Rates, ASIR）呈下降趋势（年均百分比变化[AAPC] = -0.73，95%置信区间（Confidence Interval, CI）：-0.77至-0.68），年龄标准化患病率（Age-Standardized Prevalence Rates, ASPR）（AAPC = -0.99，95% CI：-1.08至-0.9）同样呈现下降趋势。此外，胃癌的死亡人数、伤残调整寿命年总量、年龄标准化死亡率（Age-Standardized Mortality Rates, ASMR）及年龄标准化伤残调整寿命年率（Age-Standardized DALYs Rates, ASDR）均呈下降趋势。男性的胃癌疾病负担显著高于女性。本研究还发现，女性胃癌发病率与患病率的峰值年龄段为75~79岁，而男性则为70~74岁。
研究结论
胃癌仍是美国面临的重大公共卫生问题。尽管美国胃癌的年龄标准化发病率、患病率、死亡率及伤残调整寿命年率均呈下降趋势，但该国胃癌的发病例数与患病人数仍处于较高水平，疾病负担依旧沉重。未来强化预防干预措施，尤其是针对男性及60岁以上人群的干预手段，将至关重要。