Premature death patterns and trends of stomach cancer in Pudong, Shanghai: a population based study.

[BACKGROUND] Estimating the disease burden of stomach cancer is essential to developing evidence-based prevention and treatment strategies.

[AIMS] To analyze the number of deaths and the temporal trends in the mortality and years of life lost (YLL) in relation to gender, age, and the impact of aging and comorbidity via non-communicable diseases on stomach cancer burden in one of the most developed regions of a transitioning country.

[METHODS] Mortality data of stomach cancer were collected from the Vital Statistics System of the Pudong New Area, Shanghai, China, from 2005 to 2019. The long-term trends in crude mortality rates (CMR), age-standardized mortality rates worldwide (ASMRW), and rate of YLL(YLLr) were analyzed using the Joinpoint regression program. The aging and non-aging factors affecting the mortality rate were evaluated by the decomposition method.

[RESULTS] A total of 11,609 deaths from stomach cancer occurred from 2005 to 2019. The CMR and ASMRW of stomach cancer were 29.83/10 person-year and 12.20/10 person-year, respectively. The CMR, ASMRW, and YLLr in males were nearly twice as higher as those in females(CMR: 35.47/10 vs. 19.83/10, ASMRW: 15.64/10 vs. 7.74/10, YLLr: 378.63/10 vs. 229.13/10). The main co-morbidities involved the circulatory (24.64%) and respiratory system (20.62%). The main metastatic sites were liver (9.08%), lung (2.79%) and peritoneum (2.33%). The long-term trends in CMR and ASMRW were significantly decreasing in males, females, and the total population from 2005 to 2019. A total of 9,460 (81.48%) elderly people aged ≥ 60 years died of stomach cancer. The top three age groups with the highest CMR were ≥ 80 years, 70-79 years, and 60-69 years. The CMR and YLLr of people aged ≥ 80 years showed the largest significantly decreasing trends. The CMR caused by aging showed significantly upward trends [average annual percent changes (AAPC) 95%CI = 37.63(14.95,64.79)%, P < 0.001], which caused by non-aging factor showed significantly downward trends [AAPC 95%CI = -18.17(-22.83,-13.22)%, P < 0.001].

[CONCLUSION] Age is an important factor affecting the trend of disease burden of stomach cancer. Paying attention to high-risk people may help to reduce the YLL.