e15656 Background: Gastric cancer remains a major cause of cancer-related mortality in South Asia, with substantial heterogeneity across countries and sexes. Understanding long-term mortality trends and future projections is essential for guiding targeted prevention and control strategies in the region. Methods: We analyzed age-standardized mortality rates (ASMRs) for gastric cancer in South Asian countries from 1990 to 2023, using IHME GBD 2023 data. Temporal trends were assessed using estimated annual percentage change (EAPC) with 95% confidence intervals (CIs), stratified by sex. ARIMA forecasting models were applied to project mortality trends through 2050, with uncertainty quantified using prediction intervals. Results: From 1990 to 2023, gastric cancer ASMRs in South Asia showed a significant overall decline for both sexes combined (EAPC −0.84; 95% CI −0.96 to −0.71). Declines were comparable between females (EAPC −0.84; 95% CI −0.95 to −0.73) and males (EAPC −0.74; 95% CI −0.89 to −0.58), although mortality rates consistently remained higher among males. Nepal demonstrated the steepest decline across the region (both sexes EAPC −1.42), followed by India (−0.96), Bhutan (−0.69), and Pakistan (−0.43). Bangladesh exhibited a heterogeneous pattern, with modest overall reductions (EAPC −0.26). While female mortality declined significantly (EAPC −0.77; 95% CI −1.02 to −0.52), male mortality remained near stable (EAPC 0.07; 95% CI −0.01 to 0.16). Historically, ASMRs declined steadily from the early 1990s through the mid-2010s, followed by plateaus and transient increases after 2020, particularly among males. Forecasts to 2050 suggest continued regional declines driven by India and Nepal; however, Bangladesh, especially among males, is projected to experience persistent or rising mortality. Conclusions: Gastric cancer mortality in South Asia has declined substantially over the past three decades, but progress remains uneven. Stagnant mortality among Bangladeshi males and projected future increases highlight critical gaps in prevention and early detection. Targeted, sex-specific interventions will be essential to sustain and accelerate mortality reductions across the region. Location Sex EAPC Lower 95%CI Upper 95%CI Bangladesh Both -0.26 -0.40 -0.11 Bangladesh Female -0.77 -1.02 -0.52 Bangladesh Male 0.07 -0.01 0.16 Bhutan Both -0.69 -0.84 -0.53 Bhutan Female -0.65 -0.81 -0.49 Bhutan Male -0.72 -0.87 -0.57 India Both -0.96 -1.11 -0.82 India Female -0.89 -1.02 -0.77 India Male -0.90 -1.08 -0.73 Nepal Both -1.42 -1.69 -1.16 Nepal Female -1.48 -1.71 -1.24 Nepal Male -1.31 -1.60 -1.02 Pakistan Both -0.43 -0.53 -0.32 Pakistan
Hossain et al. (Thu,) studied this question.