High sodium intake: a silent killer driving global gastric cancer burden

BMC Cancer. 2025 Oct 6;25(1):1517. doi: 10.1186/s12885-025-14891-6.

Abstract

Background: High sodium intake is a recognized risk factor for increased gastric cancer mortality. This study examines the trends and distribution of stomach cancer burden associated with high sodium intake from 1990 to 2021, with a focus on its relationship with age, period, and birth cohort.

Methods: Utilizing data from the 2021 Global Burden of Disease study, we applied an age-period-cohort model to conduct statistical analysis. We calculated age, period, and cohort effects, as well as net drift (overall annual percentage change), for gastric cancer deaths and disability-adjusted life years (DALYs) associated with high sodium intake across 204 countries and regions.

Results: In 2021, 7.93% of global gastric cancer deaths and 7.92% of DALYs were linked to high sodium intake. Populations in East Asia and those with a high-middle Sociodemographic Index (SDI) bore the heaviest burden. Over the 32-year period, the global age-standardized mortality rate [Net drift = -2.33(95%CI:-2.37 to -2.28)] and age-standardized DALYs rate [Net drift = -2.56(95%CI:-2.65 to -2.47)] generally demonstrated a declining trend, particularly in high SDI regions [Net drift =-2.91 (95%CI: -3.02 to -2.81)]. China, as a representative country, exhibited unfavorable age, period, and cohort effects. Future projections suggest further declines in mortality and DALYs numbers, along with corresponding age-standardized rates.

Conclusion: Despite ongoing global efforts to reduce sodium intake, gastric cancer remains a significant public health challenge, especially in East Asia. The findings underscore the necessity of developing targeted prevention strategies for high-risk groups, such as the elderly and males, to mitigate the global burden of gastric cancer.

Keywords: Age-period- cohort; Disability-adjusted life years; Gastric cancer; Global burden of disease; Mortality; Net drift.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Disability-Adjusted Life Years
  • Female
  • Global Burden of Disease / trends
  • Global Health / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Sodium, Dietary* / adverse effects
  • Stomach Neoplasms* / epidemiology
  • Stomach Neoplasms* / etiology
  • Stomach Neoplasms* / mortality

Substances

  • Sodium, Dietary