Background Alcohol consumption is known to be a significant risk factor for cancer. In 2025, the US Surgeon General recommended adding cancer risk warning labels to alcoholic beverages, emphasizing the need for increased awareness. However, national-level data describing long-term trends in alcohol-attributable cancer mortality, including variation by age, sex, and geographic region, remain limited. This study aims to evaluate trends in alcohol-attributable cancer mortality in the USA. Methods This was a population-based observational trend analysis using data from the Global Burden of Disease database. We analyzed age-standardized mortality rates (ASMRs) and the percentage of ASMR attributable to heavy alcohol use–defined as consumption exceeding the theoretical minimum risk exposure level, in the USA from 1990 to 2023. We evaluated ASMR for all cancers combined, followed by ten specific cancers. Results (per 100,000 population) were stratified by sex, location (50 states and Washington DC), and age-groups (20–54, 55 years and older). Joinpoint regression was performed using Monte Carlo permutation testing to select the optimal model; EAPCs were reported with 95% confidence intervals and two-sided p values. All rates are reported per 100,000 population. Findings Alcohol-attributable cancer deaths in the USA doubled from 1990 (11,361) to 2023 (23,126). Mortality rates were higher in the 55 years and older age-group (19.2; 95% CI, 12.8–28.7) versus 20–54 years (2.4; 1.4–3.4), and in males (6.4; 3.8–9.7) versus females (2.1; 1.4–3.0). The percentage of mortality attributable to alcohol increased across most cancer types, age groups, and sexes, with liver cancer demonstrating the greatest increase in alcohol-attributable (113.9%). In 2023, liver (12.7; 11.2–14.4) and breast (2.4; 0.9–5.9) cancers had the highest alcohol-related mortality rates in 55 years and older males and females, respectively; in ages 20–54, colorectal (0.9; 0.4–1.4) in males and breast (0.9; 0.5–1.4) in females were highest. State-wise, the District of Columbia recorded the highest (M: 9.8; 6.0–14.1; F: 3.5; 2.2–5.2), while Utah had the lowest (M: 3.9; 2.4–5.9; F: 1.4; 0.9–2.0) ASMR. Interpretation Alcohol-attributable cancer mortality has increased in the USA, with a disproportionate burden observed in males and 55 years and older individuals. Our findings highlight the critical need for targeted prevention efforts and increased awareness to address the rising impact of alcohol consumption on cancer-related mortality. Funding No funding received for this study.

Background: Colorectal cancer is a leading cause of cancer mortality and morbidity worldwide. To guide strategies for reducing disease burden, we analysed colorectal cancer incidence, mortality, and disability-adjusted life-years (DALYs) from 1990 to 2023 at global, regional, and national levels—including the impact of selected risk factors—and forecasted trends through 2050. Methods: Colorectal cancer estimates were generated using Global Burden of Disease Study (GBD) 2023 methods, employing data from vital registration systems, population-based cancer registries, and verbal autopsies. Mortality was estimated using ensemble models, and incidence using mortality-to-incidence ratios. Years of life lost (YLLs) were generated based on death counts and GBD standard life expectancy at the age of death, and years lived with disability (YLDs) by multiplying prevalence and disability weights. YLLs and YLDs were summed to yield DALYs. Decomposition analysis was used to estimate the contributions of population growth, population ageing, colorectal cancer risk factors, and changes in rates to temporal changes in colorectal cancer DALYs. For risk factors with evidentiary links to colorectal cancer, risk-attributable DALYs were estimated based on the GBD 2023 comparative risk assessment framework. Forecasts used GBD forecasting methods and were aligned with GBD 2023 estimates. Findings: In 2023, colorectal cancer was the second-leading cause of cancer deaths (1.11 million [95% uncertainty interval, 0.997–1.21] deaths), with 2.31 million (2.03–2.58) incident cases, representing increases from 1990 of 90.4% (75.4–106.9) and 145.0% (114.3–183.1), respectively. Globally, 2023 rates of age-standardised incidence (ASIRs) and mortality (ASMRs) were 25.4 cases (22.2–28.3) and 12.3 deaths (11.0–13.4) per 100 000 population, respectively, with relatively stable global ASIR (percentage change: 3.2% [–9.5 to 18.3]) and a decrease of 21.9% (15.2–27.6) in ASMR between 1990 and 2023. In 2023, over three-fourths of global colorectal cancer cases and deaths occurred in World Bank high- and upper-middle income groups, which also experienced higher ASIRs than low- and lower-middle income groups. Notably, however, ASIRs increased between 1990 and 2023 for all groups except for high-income, where ASIR remained stable. ASMRs increased substantially in low- and lower-middle income groups, yet decreased in high- and upper-middle-income groups. In 2023, modifiable risk factors accounted for 55.7% (41.4–67.3) of the 26.2 million (23.8–28.6) global colorectal cancer DALYs, with dietary risks the leading contributor (37.2% [18.1–53.5]). Global DALYs increased by 76.4% (62.3–94.5) between 1990 and 2023, with population growth and ageing driving increases, partly offset by decreases related to risk-deleted DALY rates and risk factors. In 2050, global ASIRs and ASMRs are forecasted to be 24.6 (17.1–32.6) and 12.0 (8.9–16.4), respectively, per 100 000, while global incident cases and deaths are forecasted to rise to 4.21 million (2.76–5.81) and 2.21 million (1.50–3.20), respectively. Interpretation: Colorectal cancer is a major global health concern, with rising numbers of cases and deaths globally. While most colorectal cancer cases and deaths occurred in high- and upper-middle income countries, ASIRs and ASMRs increased in lower-middle- and low-income countries. Over half of the disease burden is linked to modifiable risk factors, most notably dietary risks. Strengthening prevention, early detection, and access to care across the resource spectrum is essential to limit future burden.

The COVID-19 pandemic complicated the understanding of and, in many ways, shaped global public health priorities, exposing systemic vulnerabilities in health systems worldwide while diverting attention and resources from other pressing threats to population health. In this editorial, a diverse panel of coauthors (n = 26) rated the nineteen greatest predefined threats to global public health in the post-pandemic era, ranging from existing to emerging causes of morbidity and mortality. The ranking was based on perceived urgency for global health policy and investment attention. Finally, the top 5 threats identified by the coauthors of this editorial were (descending order of ranking): non-communicable diseases; infectious diseases; poor mental health and substance use disorders; climate change, disasters, and humanitarian emergencies; and food insecurity, unsafe foods, and malnutrition. Besides this ranking, for each of the 19 public health threats, we summarized its scope, current evidence of burden, and rationale for its inclusion. Several threats discussed here are not new; rather, they reflect pre-pandemic trajectories that have been disrupted, delayed, or accelerated. Others, including the governance of health-related artificial intelligence and the post-pandemic intensification of loneliness and social isolation, reflect genuinely emerging concerns with limited standing in previous global health frameworks. The public health threats prioritized by this multicountry panel of coauthors warrant urgent regional and global action.

BACKGROUND:Valvular inflammation plays an important role in the progression of Rheumatic Heart Disease. We report the association between inflammatory markers and use of Benzathine Penicillin G in patients with Rheumatic mitral valve disease. METHODS:The levels of inflammatory cytokines; IL-1β, IL-6, TNF-α and inflammatory marker hs- CRP were measured using ELISA method in 32 patients with RHD receiving Benzathine Penicillin as secondary prophylaxis and 31 patients not receiving secondary prophylaxis, in a case-control study. The severity and type of valvular dysfunction were assessed with echocardiogram. RESULTS:The median level of IL-1β was significantly lower in patients on BPG (0.95 pg/ml vs. 5.47 pg/ml) p < 0.002. The median levels of IL-6, TNF-α and hs-CRP were not significantly different between study groups. The adjusted odds of raised IL-1β were lower in patients on BPG (odds ratio 0.40, 95 % C.I. 0.11, 1.45) p 0.16. There was a trend of inverse association between the use of BPG and mitral stenosis (odds ratio 0.42, 95 % C.I. (0.12, 1.46) p 0.17. CONCLUSION:Patients with RHD on BPG had lower levels of IL-1β and a trend toward a lower prevalence of mitral stenosis. Role of IL-1β in progression of incompetent to stenotic mitral valve dysfunction needs to be explored in future studies.

A 50-year-old female was evaluated for severe anaemia and melena spanning 1 week. The general physical and systemic examinations were normal, except for tachycardia and pallor. Her initial management involved intravenous fluids, proton pump inhibitors and blood transfusion. Esophagogastroduodenoscopy revealed mucosa smeared with blood in the duodenum, although no discernible lesion was observed. Duodenoscopy identified bleeding emanating from the papilla of Vater, indicative of haemosuccus pancreaticus (HP) [Figure 1a]. Her dynamic computer tomography unveiled a multilocular solid cystic lesion (6.9 cm ×9.0 cm ×7.1 cm) adjacent to the tail of the pancreas [Figure 1b]. This lesion exhibited a combination of hypo- and hyperdense contents, with sporadic peripheral and internal calcifications, suggestive of mucinous cystic neoplasm. Notably, no evidence of pseudoaneurysm or contrast extravasation was detected. Given persistent bleeding and need for repeated blood transfusions, an emergent surgical intervention was deemed necessary. She underwent a posterior radical antegrade modular pancreatosplenectomy procedure. The gross findings of the resected specimen revealed a multiloculated tumour replete with mucin and old blood [Figure 2]. Subsequent histopathological analysis confirmed carcinoma within mucinous cystadenoma. Her post-operative course progressed favourably. Sandblom in 1970 first reported gastrointestinal haemorrhage through the pancreatic duct as HP.[1] HP secondary to pancreatic tumour is extremely rare.[2]Figure 1: (a) Side-viewing endoscopy image showing bleeding from the ampulla of Vater, (b) computed tomography image showing multiloculated solid cystic lesion adjacent to the tail of pancreasFigure 2: Gross appearance of the resected tumour showing cystic cavities filled with mucin and old blood along with resected spleenDeclaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Breastfeeding is essential for enhancing a child’s immunity, neurocognitive development, growth, and future economic prospects while offering substantial benefits to mothers. This study uses extensive nationally representative data to examine the determinants of breastfeeding practices in India. The study employed data from the latest round of the Indian demographic and health survey [DHS (2019–21)]. Logistic regression and negative binomial models were used to investigate the determinants of early initiation of breastfeeding (within 1 h), exclusive breastfeeding (under 6 months), continued breastfeeding (12–23 months), and duration (months) of breastfeeding among children under the age of 2 years/23 months. In India, a female child was more likely to be exclusively breastfed for the initial 6 months [odds ratio (OR) 1.13; confidence interval (CI) (1.03–1.23)] in comparison to a male child, while the duration of breastfeeding was shorter [incidence rate ratio (IRR) 0.96; CI (0.93–0.98)]. Children born with the average size at birth [OR 1.18; CI (1.10–1.27)] and belonging to second to fourth birth order [OR 1.19; CI (1.11–1.26)] had higher odds of early initiation of breastfeeding. Notably, higher paternal educational attainment was associated with lower odds of early initiation of breastfeeding [OR 0.88; CI (0.58–0.93)] and exclusive breastfeeding [OR 0.82; CI (0.70–0.96)]. Mothers who received PNC and breastfeeding counseling during the first 2 days had higher odds of early initiation of breastfeeding [OR 1.12; CI (1.04–1.21)] and exclusive breastfeeding [OR 1.16; CI (1.03–1.31)]. Furthermore, women who received assistance from Anganwadi while breastfeeding had a higher likelihood of early initiation of breastfeeding [OR 1.26; CI (1.19–1.34)] and continuous breastfeeding [OR 1.25; CI (1.16–1.36)]. In summary, both maternal and paternal characteristics significantly influence breastfeeding practices in India. Policymakers must adopt a multi-pronged strategy that includes breastfeeding counseling, regulation of the breast milk substitute industry, provision of lactation rooms in public places, utilization of information and communication technology tools, increased paternal involvement in nursing, specialized training for health and nutrition professionals, and regular health education sessions.

In India, poor child health outcomes (CHOs) is a longstanding issue. This study examines the impact of maternal healthcare service utilization (MHCSU) on under-five CHOs, including stunting, wasting, anemia, underweight, and overweight in India, using data from the 2019-21 Indian Demographic and Health Survey. In India, a mother who consumed iron folic acid (IFA) tablets for at least 180 days [OR 0.94; 95% CI 0.9-0.99] and who received postnatal care (PNC) [OR 0.91; 95% CI 0.85-0.98] had lower odds of having an anemic child. The odds of being underweight were higher among children [OR 1.05; 95% CI 1.0-1.1] whose mothers were more than three months pregnant at the time of their first antenatal care (ANC) checkup. The skilled assistance during delivery reduced the odds of wasting [OR 0.96; 95% CI 0.92-0.99] and anemia among children. Notably, mothers who attended at least four ANC visits were more likely to have an overweight child, as each additional ANC visit has been associated with an increase in the child's weight. In summary, our results demonstrate that MHCSU has a significant impact on CHOs in India. Pertinent public health programs, increased accessibility and affordability of maternal healthcare services, greater engagement with frontline health workers, and women's empowerment can further improve CHOs in India.

This study examines the health care utilization pattern, associated financial catastrophes, and inequality across Indian states to understand the subnational variations and aid the policy makers in this regard. Data from recent National Sample Survey (2017-2018), titled, "Household Social Consumption: Health," covering 113,823 households, was employed in the study. Descriptive statistics, Erreygers concentration index (CI), and recentered influence function decomposition were applied in the study. We found that, in India, 7 percent of households experienced catastrophic health expenditure (CHE) and 1.9 percent of households were pushed below poverty line due to out-of-pocket expenditure on hospitalization. Notably, outpatient care was more burdensome (CHE: 12.1%; impoverishment: 4%). Substantial interstate variations were observed, with high financial burden in poorer states. Utilization of health care services from private health care providers was pro-rich (hospitalization CI 0.31; outpatient CI 0.10), while the occurrence of CHE incidence was pro-poor (hospitalization CI -0.10; outpatient CI -0.14). Education level, economic status, health insurance, and area of residence contributed significantly to inequalities in utilization of health care services from private providers and financial burden. The high financial burden of seeking health care necessitates the need to increase public health spending and strengthen public health infrastructure. Also, concerted efforts directed towards increasing awareness about health insurance and introducing comprehensive health insurance products (covering both inpatient and outpatient services) are imperative to augment financial risk protection in India.

Bodh, Vishal; Sharma, Brij; Chauhan, Ashish; Ahluwalia, Ajay; Sharma, Rajesh; Jindal, Keshu Author Information

The maternal mortality ratio (MMR) remains alarmingly high in South Asian countries. However, maternal healthcare service utilization (MHCSU) can significantly reduce maternal mortality and morbidity, while improving child health. Therefore, this study identifies the socio-economic and demographic factors influencing MHCSU in Afghanistan, Bangladesh, India, Maldives, Nepal and Pakistan, using data from the Demographic and Health Survey (DHS). Women who were mature (35-49 years) at the time of childbirth were more likely to receive adequate antenatal care (ANC) in Pakistan and postnatal care (PNC) in Afghanistan. Additionally, women who were educated, working, belonged to wealthier households, were aware of family planning, and had mass media exposure had higher odds of receiving MHCSU in South Asia, except in Afghanistan, where listening to the radio reduced the odds of receiving standard ANC and PNC. Notably, working mothers had lower odds of receiving ANC in Afghanistan and delivery care in Bangladesh. Additionally, women with higher childbirth orders and those lacking decision-making autonomy were less likely to receive MHCSU. A woman whose husband was educated and mature at the time of childbirth was more likely to avail MHCSU. Based on our findings, policymakers should focus on regular health education, financial incentives, adolescent-friendly health services, and enhanced e-health communication to promote MHCSU in South Asia and thereby improve maternal and child health in the region.

Background and AimVitamin E is widely prescribed for Non-alcoholic steatohepatitis (NASH).Saroglitazar, a novel dual PPAR ɑ/γ agonist, is approved in India for Non-alcoholic fatty liver disease(NAFLD).No head-to-head comparative study for vitamin E and saroglitazar is available. We studied the efficacy and safety of saroglitazar and vitamin E in NAFLD/NASH.Materials and MethodsWe prospectively randomised 175 NAFLD patients into four arms as; Saroglitazar 4mg daily alone (n=44),vitamin E 800IU daily alone (n=41), vitamin E and saroglitazar combination(n=47) and control arm (n=43). All the baseline variables including Liver stiffness measurement (LSM) and Controlled attenuation parameter (CAP) were recorded.Reassessment was done after 24 weeks of treatment.ResultsThe mean age and BMI was 45±11 years and 26±3.6 kg/m2 respectively. Compared to control, the decrease in ALT levels with saroglitazar, vitamin E and combination therapy was significant (95% CI, 6.27-28.25,p=0.002, 95% CI, -3.39-18.88, p=0.047 and 95% CI 8.10-29.54,p=0.001 respectively).The reduction in CAP was significant with saroglitazar and combination therapy (95% CI, -31.94-11.99,p=0.015 and 95% CI, -10.48-30.51,p=0.026 respectively).Only combination therapy shows significant reduction in LSM (95% CI, 0.41-1.68,p=0.001).Among glycaemic parameters, both saroglitazar alone and combination therapy significantly improved HBA1C levels (P=0.001 and P=0.015) and only combination therapy significantly improved HOMA-IR (P=0.047).Saroglitazar alone showed significant reduction in TG and LDL levels (P=0.038 and P=0.018), and combination therapy showed significant increase in HDL levels (P=0.024).ConclusionsCombination of Saroglitazar and vitamin E showed statistically significant reduction of LSM and CAP along with biochemical, glycaemic and lipid parameters.Clinical Trial Registry India no(CTRI/2022/01/039538).

Sarcopenia in cirrhosis is associated with poor survival and adverse pre and post-transplant outcomes. The study aimed at determining the prevalence of sarcopenia and its association with the severity, complications and etiology of liver disease. As many as 416 cirrhotic patients who met the inclusion criteria underwent muscle strength testing using a dynamometer. As many as 109 probable sarcopenia patients underwent computed tomography (CT) scan to measure skeletal muscle index (SMI) at the L3 vertebral level and gait-speed testing. The gender-specific cut-offs used to define sarcopenia were an SMI of 36.54 cm2/m2 in males and 30.21 cm2/m2 in females. A gait speed ≤ 0.8 m/s was taken as a cut-off to define severe sarcopenia in both genders. The mean age was 54.7 ± 9.51 years and male:female ratio was 2.2:1.The mean body mass index (BMI) was 24.2 ± 1.34 kg/m2. Alcohol and non-alcoholic steatohepatitis (NASH) were the two most common etiologies (45.9

A 60-year-old female patient presented with a 3-month history of moderate-intensity right upper quadrant abdominal pain, accompanied by nausea and occasional vomiting. Notably, there were no reported symptoms of fever, jaundice, pruritus, or weight loss. On general physical examination, the patient exhibited no discernible abnormalities. Liver function tests were normal except raised alkaline phosphatase 740 mg/dL. Her abdominal examination revealed the presence of a vague lump in the epigastric region. Her ultrasonogram revealed distended gallbladder with multiple calculi and a large (12 × 9.9 × 6.9cm) multiloculated cystic lesion with internal membranes and echogenic contents in left lobe of the liver suggestive of hydatid cyst ([Fig. 1A]). Lesion was communicating with left intrahepatic biliary radicles (IHBR) with the presence of mixed echogenic contents in common hepatic duct and common bile duct (CBD) causing mild dilation of bilobar IHBR. Her computed tomography confirmed the presence of large hydatid cyst in segments II and III with compression of segment IV, abutting left lobar biliary radicles with cystobiliary communication ([Fig. 1B]). To address the biliary obstruction and cystobiliary communication, the patient was scheduled for an endoscopic retrograde cholangiopancreatography (ERCP) procedure. Hydatid cyst membranes were extracted by balloon sweep from CBD during ERCP, following which plastic 7Fr x 7cm double pigtail stent was placed ([Fig. 1C]). The procedure was uneventful. The patient was treated with oral albendazole and attached to surgery for further management.

A 44-year-old male patient, a known case of bronchial asthma, presented with the chief complaints of fever for the last 3 weeks, shortness of breath, and passage of fresh blood in stools. There was a history of loose stools for the same duration, four to five times in frequency, small in volume. He also had anorexia and weight loss. The patient had low fever, intermittent, not associated with chills and rigors and it seldom crossed 100°F. The diarrhea was associated with tenesmus. There was a past history of pulmonary tuberculosis (TB; sputum positive) 11 years back for which the patient received antitubercular therapy for 6 months. Physical examination revealed mild pallor and chest examination was suggestive of tracheal shift to left side and crepts in left supraclavicular area. Except this, the rest of general and the systemic examination were essentially normal. Digital rectal examination was performed and it was normal.

Background Cancers represent a challenging public health threat in Asia. This study examines the temporal patterns of incidence, mortality, disability and risk factors of 29 cancers in Asia in the last three decades. Methods The age, sex and year -wise estimates of incidence, mortality, and disability -adjusted life years (DALYs) of 29 cancers for 49 Asian countries from 1990 through 2019 were generated as a part of the Global Burden of Disease, Injuries and Risk Factors 2019 study. Besides incidence, mortality and DALYs, we also examined the cancer burden measured in terms of DALYs and deaths attributable to risk factors, which had evidence of causation with different cancers. The development status of countries was measured using the socio-demographic index. Decomposition analysis was performed to gauge the change in cancer incidence between 1990 and 2019 due to population growth, aging and age -specific incidence rates. Findings All cancers combined claimed an estimated 5.6 million [95% uncertainty interval, 5.1-6.0 million] lives in Asia with 9.4 million [8.6-10.2 million] incident cases and 144.7 million [132.7-156.5 million] DALYs in 2019. The agestandardized incidence rate (ASIR) of all cancers combined in Asia was 197.6/100,000 [181.0-214.4] in 2019, varying from 99.2/100,000 [76.1-126.0] in Bangladesh to 330.5/100,000 [298.5-365.8] in Cyprus. The age -standardized mortality rate (ASMR) was 120.6/100,000 [110.1-130.7] in 2019, varying 4 -folds across countries from 71.0/100,000 [59.9-83.5] in Kuwait to 284.2/100,000 [229.2-352.3] in Mongolia. The age -standardized DALYs rate was 2970.5/ 100,000 [2722.6-3206.5] in 2019, varying from 1578.0/100,000 [1341.2-1847.0] in Kuwait to 6574.4/100,000 [5141.7-8333.0] in Mongolia. Between 1990 and 2019, deaths due to 17 of the 29 cancers either doubled or more, and 20 of the 29 cancers underwent an increase of 150% or more in terms of new cases. Tracheal, bronchus, and lung cancer (both sexes), breast cancer (among females), colon and rectum cancer (both sexes), stomach cancer (both sexes) and prostate cancer (among males) were among top -5 cancers in most Asian countries in terms of ASIR and ASMR in 2019 and cancers of liver, stomach, hodgkin lymphoma and esophageal cancer posted the most significant decreases in age -standardized rates between 1990 and 2019. Among the modifiable risk factors, smoking, alcohol use, ambient particulate matter (PM) pollution and unsafe sex remained the dominant risk factors between 1990 and 2019. Cancer DALYs due to ambient PM pollution, high body mass index and fasting plasma glucose has increased most notably between 1990 and 2019. Interpretation With growing incidence, cancer has become more significant public health threat in Asia, demanding urgent policy attention and guidance. Its heightened risk calls for increased cancer awareness, preventive measures, affordable early -stage detection, and cost-effective therapeutics in Asia. The current study can serve as a useful resource for policymakers and researchers in Asia for devising interventions for cancer management and control. Funding The GBD study is funded by the Bill and Melinda Gates Foundation. Copyright (c) 2023 The Author. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Background Stomach cancer is a global health problem and is one of the leading causes of cancer deaths worldwide. This study investigates the spatial and temporal patterns of stomach cancer burden in 204 countries in the last three decades. Data and Methods The estimates of stomach cancer burden and its risk factors were obtained from the Global Burden of Disease (GBD) 2019 study, covering the years 1990 to 2019, across 204 countries within 21 world regions. GBD employs the cause-of-death ensemble modeling framework to calculate disease-specific mortality estimates. Estimated average percent change (EAPC) of absolute counts (incidence, mortality, and disability-adjusted life years (DALYs)) and age-standardized rates (age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDALR)) was calculated in the regions to illustrate the relative changes between 1990 and 2019. Joinpoint regression was used to analyze global trends of stomach cancer burden in the last three decades. Results Incidence of stomach cancer globally increased from 883,396 cases in 1990 to 1.3 million cases in 2019 and number of deaths due to stomach cancer rose from 788,317 in 1990 to 957,185 in 2019. Between 1990 and 2019, the global ASIR decreased from 22.4 per 100,000 to 15.6 per 100,000, the ASMR decreased from 20.5 per 100,000 to 11.9 per 100,000 and the ASDALR declined from 493.4 per 100,000 to 290.6 per 100,000. Trend analysis using joinpoint regression revealed the slowest rise in incident cases and largest decline in ASIR between 2004 and 2016. In 2019, East Asia had the highest number of incident cases, totaling 626,489, followed by high-income Asia-Pacific (128,168) and South Asia (99,399). The ASIR was the highest in East Asia (30.2/100,000) followed by high-income Asia-Pacific (28.2/100,000) and Andean Latin America (22.4/100,000), while high-income North America had the lowest ASIR at 6.1/100,000. In terms of absolute counts, the top three countries in 2019 were China, India, and Japan together accounting for 61.5% of global incident cases, 58.6% of deaths, and DALYs. Mongolia had the highest ASIR (43.7 per 100,000), followed by Bolivia (34.0 per 100,000) and China (30.6 per 100,000) in 2019, while the lowest ASIR was 3.3 per 100,000 in Malawi. Globally, for both sexes combined, 7.8% of stomach cancer DALYs were associated with a diet high in sodium and 17.2% were linked to smoking. Among males, 24.0% of stomach cancer DALYs were attributable to smoking, compared to only 4.3% in females in 2019. Conclusion Significant progress has been made globally in the fight against stomach cancer, with the ASIR decreasing by 30.3% and the ASMR by 41.2% between 1990 and 2019. To further reduce the burden of stomach cancer, it is essential to address factors such as Helicobacter pylori prevalence, obesity, and smoking. Additionally, improvements in early detection, socioeconomic development (including better public sanitation, hygiene, and drinking water), and dietary habits are imperative.