Beware of the Big C!

As many as 15.6 million of today's youngsters — born between 2008 and 2017 — are likely to develop gastric cancer in the future, says a July 2025 study published in Nature Medicine. Nearly 42% of the cases will be in India and China.

The study (bit.ly/Gastric-Park) by scientists at the International Agency for Research on Cancer (IARC), Lyon, France, states that the incidence is preventable in most cases, and three-fourths of it is caused by the bacterium Helicobacter pylori, commonly found in the stomach. The number of gastric cancer cases was quantified examining data on its incidence from 185 countries in 2022, combining national age-specific incidence rates from GLOBOCAN 2022 — the latest global cancer statistics report — and cohort-specific mortality rates from United Nations demographic data.

The authors, led by IARC scientists Jin Young Park and Iacopo Baussano, call for greater investment in the prevention of gastric cancer through population-wide screening and treatment programmes, such as those effectively implemented in Japan and South Korea. While such prevention and control programmes exist for cervical cancer caused by the human papillomavirus and viral hepatitis, there is no effective population-wide control programme for H. pylori in most countries.

Gastric cancer is the fifth-leading cause of cancer-related deaths worldwide. Though largely preventable, it has high morbidity and poor prognosis. And unless there is a change in current gastric cancer control measures, the rising incidence among younger generations, combined with ageing and growing populations, will reverse recent efforts to reduce the disease incidence and mortality. Projections on the burden of future gastric cancer cases are needed to determine mitigation strategies, they add.

The study highlights the growing burden of gastric cancer with shifting global profiles. The projections provide policymakers with critical information for cancer control planning at both regional and national levels, underscoring the urgent need for the implementation of prevention strategies to reduce the global burden of gastric cancer.

They project that 10.6 million new gastric cancer cases will occur in Asia, with 6.5 million cases in India and China alone. Although sub-Saharan Africa currently has a relatively low burden of gastric cancer, projections suggest that its future burden could be at least six times higher than estimated in 2022. However, in modelling the impact of population-level H. pylori screen-and-treat strategies, Park and co-authors found that the expected number of gastric cancers could be reduced by up to 75%.