Table 1
State‑level incidence, deaths and DALYs of gastric cancer (1990–2021).
| Incidence (95% UI) | Deaths (95% UI) | DALYs (95% UI) | |||||||
| 1990 | 2021 | Percentage change, 1990–2021 | 1990 | 2021 | Percentage change, 1990–2021 | 1990 | 2021 | Percentage change, 1990–2021 | |
| United States of America | |||||||||
| Absolute number, thousands | 25.71 [24.11–26.59] | 28.46 [26.39–29.87] | 10.69% [7.15% to 14.23%] | 17.32 [16.09–17.98] | 16.44 [15.03–17.35] | −5.22% [−8.10% to −2.28%] | 383.16 [366.57–393.93] | 363.14 [342.10–377.92] | −5.22% [−8.10% to −2.28%] |
| Age‑standardized rate, per 100,000 | 8.04 [7.57–8.30] | 5.07 [4.74–5.30] | −36.97% [−38.82% to −35.11%] | 5.36 [4.99–5.55] | 2.84 [2.62–2.98] | −44.63% [−46.23% to −43.02%] | 124.90 [120.01–128.28] | 69.16 [65.84–71.77] | −44.63% [−46.23% to −43.02%] |
| Incidence (95% UI) | Deaths (95% UI) | DALYs (95% UI) | |||||||
| Top five states, age‑standardized rate, 2021 | |||||||||
| Hawaii | 7.88 | Hawaii | 4.31 | Hawaii | 106.00 | ||||
| Louisiana | 6.70 | Mississippi | 3.92 | Mississippi | 98.88 | ||||
| Mississippi | 6.05 | Louisiana | 3.69 | Louisiana | 92.79 | ||||
| New Mexico | 6.02 | District of Columbia | 3.66 | New Mexico | 92.65 | ||||
| Alaska | 6.01 | Alabama | 3.57 | District of Columbia | 91.58 | ||||
| Bottom five states, age‑standardized rate, 2021 | |||||||||
| Idaho | 3.82 | Vermont | 2.16 | Idaho | 49.93 | ||||
| Vermont | 3.96 | Iowa | 2.17 | Vermont | 51.09 | ||||
| Utah | 4.03 | Idaho | 2.19 | Iowa | 51.52 | ||||
| Iowa | 4.10 | Oregon | 2.20 | Utah | 51.56 | ||||
| Oregon | 4.17 | Washington | 2.24 | Washington | 52.68 | ||||
[i] DALYs: disability‑adjusted life years.
[ii] See Table 1 for a summary; full state‑level results with 95% UIs are provided in Supplementary Table S1.
Figure 1
Age‑standardized (A) incidence, (B) death, and (C) DALY rate of GC in the United States, 2021.
DALYs = Disability‑adjusted life years.
Figure 2
Correlation between SDI and age‑standardized DALY rates of gastric cancer in the United States by state, 2021.
DALYs = Disability‑adjusted life years.
Ribbon indicates 95% confidence interval.
Table 2
Multiple regression between incidence, deaths, DALYs, prevalence, YLDs, and YLLs count of gastric cancer and racial/ethnic population, 2021, United States.
| MEASURE | HISPANIC | WHITE | BLACK | ASIAN | ||||
|---|---|---|---|---|---|---|---|---|
| β (95% CI) | P‑VALUE | β (95% CI) | P‑VALUE | β (95% CI) | P‑VALUE | β (95% CI) | P‑VALUE | |
| Incidence | 0.053 [0.039, 0.067] | <0.001 | 0.084 [0.074, 0.094] | <0.001 | 0.128 [0.099, 0.158] | <0.001 | 0.220 [0.178, 0.262] | <0.001 |
| Deaths | 0.032 [0.023, 0.041] | <0.001 | 0.049 [0.043, 0.056] | <0.001 | 0.068 [0.049, 0.087] | <0.001 | 0.122 [0.095, 0.150] | <0.001 |
| DALYs | 0.925 [0.745, 1.106] | <0.001 | 0.965 [0.838, 1.092] | <0.001 | 1.705 [1.324, 2.087] | <0.001 | 2.568 [2.027, 3.109] | <0.001 |
| Prevalence | 0.145 [0.102, 0.187] | <0.001 | 0.219 [0.189, 0.249] | <0.001 | 0.330 [0.240, 0.420] | <0.001 | 0.628 [0.500, 0.755] | <0.001 |
| YLDs | 0.017 [0.013, 0.022] | <0.001 | 0.026 [0.023, 0.029] | <0.001 | 0.038 [0.029, 0.048] | <0.001 | 0.065 [0.052, 0.078] | <0.001 |
| YLLs | 0.908 [0.730, 1.085] | <0.001 | 0.939 [0.814, 1.065] | <0.001 | 1.667 [1.292, 2.042] | <0.001 | 2.503 [1.971, 3.035] | <0.001 |
Table 3
Multiple regression between DALYs of gastric cancer and race/ethnicity and mediation analysis with aggregate household income and educational attainment.
| MODEL | VARIABLE | HISPANIC | WHITE | BLACK | ASIAN | ||||
|---|---|---|---|---|---|---|---|---|---|
| β (95% CI) | P‑VALUE | β (95% CI) | P‑VALUE | β (95% CI) | P‑VALUE | β (95% CI) | P‑VALUE | ||
| Multiple regression | Racial/ethnic population | 1.293 [1.003, 1.584] | <0.001 | 1.542 [1.150, 1.934] | <0.001 | 1.901 [1.479, 2.323] | <0.001 | 4.616 [3.200, 6.032] | <0.001 |
| Aggregate household income | β (95% CI) = −34.419 [−60.265, −8.572] p‑value = 0.010 | ||||||||
| Education attainment | β (95% CI) = 3.097 [0.106, 6.087] p‑value = 0.043 | ||||||||
| Mediation analysis | Total effect | 0.925 [0.723, 1.502] | <0.001 | 0.965 [0.777, 1.098] | <0.001 | 1.705 [1.327, 2.542] | <0.001 | 2.568 [−0.062, 3.142] | 0.003 |
| Direct association | 1.293 [0.926, 1.987] | <0.001 | 1.542 [1.028, 1.938] | <0.001 | 1.901 [1.377, 2.790] | <0.001 | 4.616 [0.453, 6.096] | <0.001 | |
| Indirect association (combined) | −0.368 [−0.754, 0.014] | 0.041 | −0.577 [−0.989, −0.023] | 0.013 | −0.196 [−0.590, 0.192] | 0.297 | −2.048 [−3.887, 0.087] | 0.034 | |
| Indirect association (income) | −0.802 [−1.425, 0.365] | 0.067 | −1.368 [−2.349, 0.401] | 0.052 | −1.002 [−2.083, 0.213] | 0.084 | −4.074 [−8.691, 1.814] | 0.121 | |
| Indirect association (education) | 0.434 [−0.515, 0.869] | 0.215 | 0.791 [−0.599, 1.544] | 0.152 | 0.807 [−0.430, 1.861] | 0.167 | 2.026 [−2.596, 6.124] | 0.32 | |
| Proportion mediated* (%) | 22.168 | 27.223 | 9.336 | 30.731 | |||||
[i] *To address the opposing signs between indirect and direct effects, we calculated the proportion mediated using the absolute values of the effects.