Global burden of gastric cancer in adolescents and young adults: estimates from GLOBOCAN 2020.

Objectives: Gastric cancer in adolescents and young adults (GCAYA) has been ignored by both patients and physicians. We examined the disease burden of GCAYA and its secular trends in incidence and mortality.
Study Design: A comprehensive analysis of the global burden of GCAYA based on data provided by GLOBOCAN 2020.
Methods: Global, regional, sex, and country-specific data of the incidence and mortality of GCAYA were extracted from the GLOBOCAN, the Cancer in Five Continents Plus, and the World Health Organization mortality database, respectively. The associations between the Human Development Index (HDI) and GCAYA burden were also evaluated by Pearson correlation analysis.
Results: The global incidence of GCAYA was 0.79 per 100,000, and the corresponding mortality was 0.45 per 100,000 in 2020. The mortality-to-incidence ratio (MIR) was lower in AYA (0.61) than in patients aged 40-64 years (0.65) and patients aged 65 years and older (0.75). The age-standardized incidence rates (ASIR) and age-standardized mortality rates (ASMR) were 0.84 and 0.53 per 100,000, respectively, in women, compared with 0.74 and 0.45 per 100,000, respectively, in men. The majority of new cases (17,934) and deaths (10,360) were estimated to occur in Asia. There has a significant negative correlation between the MIR of GCAYA and HDI level (R ²  = 0.2707, P < 0.0001). There was a decreasing trend of incidence and mortality in most countries.
Conclusions: The MIR of GCAYA is lower than that among older patients and exhibit a positive association with socio-economic status. The incidence and mortality of GCAYA show a decreasing trend in most countries.
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