Objective To analyze the trend of gastric cancer incidence among the registered residents in Wenzhou of Zhejiang Province from 2014 to 2023, and to provide a scientific basis for gastric cancer prevention and control.

Methods The data of gastric cancer that met the requirements were collected from the Wenzhou Chronic Disease Monitoring and Management Information System from 2014 to 2023. The registration covered all counties (cities and districts) and all registered residents in Wenzhou City, stratified by gender and age. The crude incidence rate, China age-standardized incidence rates by chinese standard population (ASRC) and age-standardized rate by world standard population (ASRW), truncated age-standardized incidence rate (35‒64 years) and cumulative rate (0‒74 years old) were calculated. The average annual percentage change (AAPC) was used to analyze the incidence trend of gastric cancer.

Results From 2014 to 2023, the crude incidence rate of gastric cancer in Wenzhou was 34.13/10⁵, ranking the 4^th in the incidence sequence of malignant tumors. There was no significant trend over the years (AAPC=-0.327%, P>0.05). The ASRC and ASRW of gastric cancer were 20.16/10⁵ and 19.80/10⁵, respectively, both showing a downward trend (AAPC=-3.227%, -3.235%, P<0.05). The truncated age-standardized incidence rate (35‒64 years) was 26.40/10⁵ and the cumulative rate (0‒74 years old) was 5.61%. The crude incidence rate, ASRC, ASRW, truncated age-standardized incidence rate (35‒64 years) and cumulative rate (0‒74 years old) of gastric cancer in men were all higher than those in women. From 2014 to 2023, the crude incidence rates of gastric cancer in both men and women did not show a time-varying trend (both P>0.05), while the ASRC and ASRW showed a downward trend (for men: AAPC=-3.427%, -3.496%, both P<0.05; for women: AAPC=-2.184%, -2.099%, both P<0.05). The age-specific incidence rate of gastric cancer showed an upward trend with the increase of age. The crude incidence rate of gastric cancer increased significantly after the age of 45 and reached a peak in the age group of 80 to 84 years old, and then decreased. The crude incidence rates of gastric cancer among residents in the age groups of 15 to 44 years old and 45 to 54 years old showed a downward trend (AAPC=-4.622%, -3.147%, both P<0.05), while there was no significant trend in the age groups of 55 to 64 years old and 65 years old and above (AAPC=-1.487%, 1.315%, both P>0.05). The main sites of gastric cancer were concentrated in the gastric antrum, stomach body, and cardia.

Conclusion From 2014 to 2023, the crude incidence rate of gastric cancer remained stable in Wenzhou, but the standardized incidence rate showed a downward trend. Men, middle-aged and elderly people were high-risk groups. Therefore, intervention measures should be carried out against risk factors, and screening and eradication of Helicobacter pylori infection as well as early screening for gastric cancer should be strengthened to reduce the incidence rate of gastric cancer.