Global burden, trends, and inequalities of gastric cancer attributable to high-sodium diets: a 30-year analysis and projections based on the global burden of disease 2021 study.

[BACKGROUND] High-sodium diet is a modifiable risk factor for gastric cancer, contributing substantially to its global burden. However, comprehensive evaluations of temporal, geographic, and sociodemographic patterns remain limited.

[METHODS] Using Global Burden of Disease (GBD) 2021 data, we systematically assessed gastric cancer mortality and disability-adjusted life years (DALYs) attributable to high-sodium diets across 204 countries and territories from 1990 to 2021. Analytical approaches included joinpoint regression, age-period-cohort models, frontier efficiency, inequality metrics, and Bayesian projections to 2036.

[RESULTS] Globally, age-standardized mortality and DALY rates declined significantly from 1990 to 2021 (EAPC for mortality: -2.26%; DALYs: -2.88%). The highest burden was observed in East Asia, with China and Mongolia being most affected. Disparities across sex, region, and sociodemographic index (SDI) persisted, with middle and high-middle SDI countries exhibiting peak age-standardized rates. Reductions were most pronounced in high SDI and high-income Asia-Pacific regions. Inequality, while reduced in absolute terms, remained evident. Projections indicate continued declines, but persistent regional differences.

[CONCLUSIONS] Despite global progress in reducing age-standardized rates, substantial absolute and relative disparities in gastric cancer burden attributable to high-sodium diets persist, especially in transitioning economies. Targeted policies combining sodium reduction, education, regulation, and improved healthcare access are vital to accelerate progress and achieve more equitable health gains worldwide.