Global lifetime estimates of expected and preventable gastric cancers across 185 countries

Chronic infection with Helicobacter pylori is a modifiable cause of gastric cancer. To assist policymakers in advocating for and planning prevention strategies, we projected the future burden of gastric cancer, including that attributable to H. pylori, among a cohort of young people born in 2008-2017. Expected gastric cancer cases, in the absence of intervention, were quantified in 185 countries by combining national age-specific incidence rates from GLOBOCAN 2022 and cohort-specific mortality rates from the United Nations' demographic projections. Globally, 15.6 million (95% uncertainty interval 14.0-17.3 million) lifetime gastric cancer cases are expected within these birth cohorts, 76% of which are attributable to H. pylori. Two-thirds of cases will be concentrated in Asia, followed by the Americas and Africa. Whereas 58% of cases are expected in traditionally high-incidence areas for gastric cancer, 42% of cases are expected to occur in lower-incidence areas owing to demographic changes, particularly in sub-Saharan Africa, where the future burden could be six times greater than estimated in 2022. A shift in focus toward the life course of today's young people and their prospects of developing gastric cancer, with or without effective interventions, underscores the need for greater investment in gastric cancer prevention, including the implementation of population-based H. pylori screen-and-treat strategies.