This study compares stomach cancer-related mortality rates in Japan with those in European and Asian countries and analyzes trends in stomach cancer-related mortality rates according to gender in young Japanese over the period of 1957-1997. From official death certification numbers and population estimates, we obtained stomach cancer-related mortality rate for all ages and various ages according to gender. Japan's ranking compared to other countries in death percentage of all cancers which are attributable to stomach cancer was fourth for both men and women. In Japan and Ireland, total elimination of deaths from stomach cancer in men resulted in increased life expectancy of 0.68 and 0.22 y respectively, whereas the corresponding figures for women were 0.42 and 0.14 y respectively. The sex ratios of stomach cancer-related mortality rates were 0.75, 0.63, 0.80 and 0.94 for 25-29, 30-34, 35-39 and 40-44 y age groups, respectively, in 1997. The sex ratio of relative risk ranged from 0.62 to 0.92 in 25-40 y age groups during the observation period. The life expectancy in 30-34 y age group increased by 0.66 y for men and 0.41 y for women in 1995 after elimination of stomach cancer-related deaths. Our results suggest that stomach cancer-related mortality rates are still high in Japan and young women are at higher risk of stomach cancer-related death relative to young men and that sex ratio is stable or slightly decreased over the 40-y period. It is important to monitor this trend continuously in the next few years.