Global stomach cancer burden from high-sodium diet and smoking: 1990–2021 findings & 2040 projections

Background: Stomach cancer remains a major global health burden, and high sodium intake and smoking are key modifiable risk factors, yet their long-term and future contributions to global mortality and disability remain unclear. Objective: (1) assess the global burden of stomach cancer linked to high sodium intake and smoking from 1990 to 2021; (2) forecast the burden from 2021 to 2040. Methods: We used Global Burden of Disease 2021 data to calculate age- and sex-specific death and DALYs rates, percentage changes, and population attributable fractions for high sodium intake and smoking. Results: In 2021, 7.9% and 11.2% of global age-standardized stomach cancer deaths were attributed to high sodium intake and smoking, respectively, with men and older adults most affected. East Asia had the highest death and DALY rates, and High-income North America and Western Sub-Saharan Africa the lowest; Mongolia and Bolivia topped sodium-related rates, while Morocco and Nigeria were lowest. From 1990 to 2021, sodium-related mortality rose most in Egypt and fell most in South Korea; smoking-related deaths rose in Egypt and Lesotho but fell in Singapore. High-middle SDI regions bore the greatest burden, and projections to 2040 predict global declines in death and DALY rates for both risks. Conclusions: Our findings highlight the need for targeted, region- and gender-specific policies to curb stomach cancer risk from high sodium intake and smoking, providing policymakers with vital data for effective public health interventions.