Gastric cancer incidence trends in China and Japan from 1990 to 2019: Disentangling age–period–cohort patterns

Abstract

Background: Recent data have shown divergent trends in gastric cancer (GC) incidence between China and Japan; however, the cause for has not been explored. Methods:We retrieved GC incidence data from 1990 to 2019 from the Global Burden of Disease study, stratified by sex for both countries. We analyzed annual average percentage change (AAPC) via a joinpoint regression model and estimated the effects of age, period, and cohort via the age-period-cohort model. Results:The age-standardized incidence rate trends for GC decreased in both countries and both sexes, but the reduction was more pronounced in Japan because the AAPC for Japanese males (AAPC = −2.65%; 95% CI, −2.98 to −2.32) was eight times greater than that of Chinese males (AAPC = −0.30%; 95% CI, −0.5 to −0.09).The age and cohort effects on the trend are similar in both countries: the risk of GC incidence increased with age among the Chinese and the Japanese but was lower among younger birth cohorts. The two countries showed contrasting trends over the study period; although the risk of GC rapidly decreased for Japanese males and females, it increased by twofold among Chinese males. Conclusions:The period effect is the main reason for the divergent trends in agestandardized incidence rate for GC in China and Japan. By comparing national cancer control programs in both countries, we concluded that countries with a high prevalence of GC, such as China, can learn from Japan's experience in controlling GC by actively conducting national population screening, which is expected to facilitate both prevention and treatment of GC. Lay summary:� More than one-half of all new gastric cancer (GC) worldwide occur in China and Japan, but the reasons for the different incidence trends have not been thoroughly analyzed.� Analysis using the age-period-cohort model confirmed that the cohort effect was the main reason for the decline in age-standardized incidence rate (ASIR) for GCThe first two authors contributed equally to this article.

Trends of gastric cancer burdens attributable to risk factors in China from 2000 to 2050

“… 25 , 26 Effective implementation of a national public health program focused on cancer prevention and control from an early period has also greatly contributed to a significant decline in the incidence of GC in Japan. 27 In contrary to the controversial results on the association of H. pylori infection with CGC in Western populations, most Asian studies showed a positive association between H. pylori and CGC, though more modest than that of NCGC. 28 Evidence from multiplex serology indicates diverse associations between individual antigens and CGC and NCGC, as well as distinct pathogenic effects for a single H. pylori virulence factor across different ethnicities.…”

Long-term trends in the burden of colorectal cancer in Europe over three decades: a joinpoint regression and age-period-cohort analysis

“…RR = exp (effect coefficient), with larger RR values indicating a higher risk of incidence or mortality.RR values above 1 indicate a higher risk of incidence or mortality relative to the average. Conversely, RR values less than 1 suggest a lower risk of incidence or mortality relative to the average ( 18 ).…”

Disease burden of COPD attributable to PM2.5in China, Japan and South Korea from 1990 to 2019: a comparative study based on Global Burden of Disease Study 2019

“…However, previous studies have mainly focused on analysing the effect of PM 2.5 on COPD and its potential mechanisms in a particular country or global,26 27 and few studies have analysed the disease burden of COPD due to APM and HAP in three countries, China, Japan and Korea,25 while few studies have been able to further investigate the age, period and cohort effects of PM 2.5 and COPD using the age-period-cohort (APC) model 25 27. APC models are able to estimate the independent effects of age, period and cohort on disease,28 helping us to understand COPD caused by PM 2.5 from a historical perspective, such as disease screening modalities, treatments or interventions and lifestyle changes 29 30. Therefore, this study subdivided PM 2.5 into HAP and APM, aiming to analyse the changes in COPD disease burden attributable to PM 2.5 and its age, period and cohort effects in China, Japan and Korea from 1990 to 2019 and to provide feasible and targeted policy recommendations for countries and regions with high disease burden.…”