A Study on the Burden of Gastric Cancer Attributable to Excess Sodium Intake Based on the Global Burden of Disease and Global Dietary Databases

Background: Excess sodium intake is linked to gastric cancer (GC). However, global sodium intake trends and associated GC burden dynamics remain unclear. This study analyzed global sodium intake patterns and GC burden attributable to excess sodium to inform targeted interventions.

Methods: This study was conducted using data from the Global Burden of Disease (GBD) database (which provides GC disease burden data from 1990 to 2021) and the Global Dietary Database (GDD) (which provides sodium intake data from 1990 to 2018). GC disease burden was assessed in multiple dimensions using various indicators and a variety of dedicated analytical models. Additionally, the Bayesian Age-Period-Cohort (BAPC) model was applied to predict the trend in the GC disease burden up to 2050.

Results: From 1990 to 2018, global sodium intake trended upward, with adults exhibiting higher intake levels than children. Sodium intake also displayed a “first increasing then decreasing” pattern with age, with males presenting a higher intake than females. The regional pattern of high intake in Asia and low intake in Sub-Saharan Africa (SSA)remained stable across educational levels and urban-rural stratifications. In 2021, the global and regional age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life year rate (ASDR) of GC linked to excess sodium were lower than those in 1990 (the estimated annual percentage change (EAPC) was negative in most regions); however, GC fatalities increased. Males and the elderly exhibited a heavier burden of GC, with East Asia being identified as a significantly high-incidence region. Health inequality narrowed (according to the lower slope index of inequality (SII)). The Bayesian Age-Period-Cohort (BAPC) model predicts a sustained reduction in GC burden by 2050, contingent upon the continuation of current prevention/control efforts.

Conclusion: The excess sodium-related GC burden is decreasing globally; however, regional disparities persist. Targeted salt reduction and healthcare investment, especially in low-SDI regions, would accelerate the progress toward reducing this burden.