National trend of gastric cancer mortality in China (2003-2015): a population-based study

Background: Gastric cancer mortality decreased substantially over the last decades in most countries worldwide. This study aimed to assess the most recent national trend of gastric cancer mortality and examine the disparity of gastric cancer mortality between rural and urban areas in China. Methods: The crude mortality data of gastric cancer by sex, age group, and area were obtained from China Health Statistical Yearbooks (2003-2015) covering 10% of Chinese population. The age-standardized rates of mortality (ASRM) of gastric cancer in rural and urban areas were estimated using the 2010 Chinese Census population stratified by age, sex, and area. The trend of mortality of gastric cancer was assessed by using Joinpoint analysis. Results: During the 13-year period, the ASRM was reduced from 31.5/100,000 in 2003 to 20.9/100,000 in 2015 in rural areas and from 18.9/100,000 in 2003 to 14.5/100,000 in 2015 in urban areas. In the male population, the annual percent changes of mortality were -2.2% in urban areas (95% confidence interval [CI] -3.8% to -0.6%; P<0.001) and -3.4% in rural areas (95% CI -5.1% to -1.8%; P<0.001). In the female population, the annual percent changes of mortality were -2.7% in urban areas (95% CI -4.2% to -1.2%; P<0.001) and -4.6% in rural areas (95% CI -5.5% to -3.7%; P<0.001). Conclusions: The declining trend of mortality of gastric cancer was presented from 2003 to 2015 in both rural and urban areas in China. The decrease in gastric cancer mortality is greater in rural areas than in urban areas in China.