Background and objective: Gastric cancer (GC), the fourth leading cause of global cancer-related mortality, is closely associated with modifiable risk factors, particularly a high-sodium diet. Although high sodium intake is a well-established etiological driver of GC, the spatiotemporal patterns of this risk factor and its evolving disease burden at global, regional, and national levels remain systematically unassessed. Methods: Data from 204 countries/territories on diet high in sodium-attributable gastric cancer (DHSAGC), including age-standardized mortality rates (ASMR) and disability-adjusted life years rates (ASDR), were extracted via the Global Health Data Exchange (GHDx) platform. Joinpoint regression and estimated annual percentage change (EAPC) were used to quantify burden trends. Associations with the socio-demographic index (SDI) and geographical clustering were evaluated using Pearson correlation and hierarchical clustering. The burden of dual exposure to high sodium and H. pylori was compared across exposure groups. Results: In 2021, DHSAGC led to approximately 75 661 deaths and 1.80 million DALYs globally, representing increases of 11.5% and a decrease of 2.2% since 1990, respectively. Although the age-standardized rates declined globally (ASMR EAPC = −2.26%; ASDR EAPC = −2.56%), the absolute death burden increased. Significant sex and geographic disparities persisted, with males and East Asian regions bearing the highest burden. The ASMR and ASDR demonstrated an inverted U-shaped relationship with SDI, peaking in middle-SDI countries. Countries with concurrent high sodium intake and high H. pylori prevalence faced a substantially greater disease burden than those with single or low exposures. Conclusion: Despite declines in ASMR and ASDR, absolute deaths and DALYs have increased due to population aging and sustained high-sodium exposure. Future strategies must integrate salt reduction with H. pylori eradication, particularly in middle-/low-SDI regions, to mitigate the rising global burden of GC.
叶晔捷 et al. (Wed,) studied this question.