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Abstract

<jats:p>&lt;div&gt;Abstract Background:&lt;p&gt;Gastric cancer is a major global health burden, but histologic subtype-specific epidemiologic and survival trends remain unclear. We aimed to characterize these trends in the United States and compare stage and survival in a Chinese cohort.&lt;/p&gt; Methods:&lt;p&gt;We analyzed data from the US Surveillance, Epidemiology, and End Results (SEER) 17 registries (2000–2022) to estimate age-adjusted incidence, incidence-based mortality, and mortality-to-incidence ratio (MIR) for five histologic subtypes: gastric adenocarcinoma, gastric neuroendocrine tumor (G-NET), gastric neuroendocrine carcinoma/mixed neuroendocrine–non-neuroendocrine neoplasm (G-NEC/MiNEN), gastric carcinoma with squamous component (GCSC), and undifferentiated gastric carcinoma. Joinpoint regression was used to estimate the average annual percentage change (AAPC). Stage, 5-year overall survival (OS), and relative survival were assessed in SEER (2000–2017), and stage and 5-year OS in a Chinese cohort (2010–2020).&lt;/p&gt; Results:&lt;p&gt;From 2000 to 2022, the case composition of gastric cancer shifted by histologic subtype: Gastric adenocarcinoma remained predominant but declined proportionally. Incidence decreased for gastric adenocarcinoma (AAPC, −1.74%) and GCSC (−1.37%) but increased for G-NET (4.37%) and G-NEC/MiNEN (3.67%). Mortality increased for G-NET and G-NEC/MiNEN, whereas MIR increased for gastric adenocarcinoma and G-NET. Stage distributions differed across subtypes. In SEER, 5-year OS was the highest for G-NET (83.3%) and lowest for GCSC (12.3%). In the Chinese cohort, 5-year OS was higher for gastric adenocarcinoma (48.4%) but lower for G-NEC/MiNEN (22.4%) than in SEER, paralleling fewer stage IV gastric adenocarcinoma and fewer stage I G-NEC/MiNEN.&lt;/p&gt; Conclusions:&lt;p&gt;Gastric cancer subtypes show distinct epidemiologic and prognostic patterns.&lt;/p&gt; Impact:&lt;p&gt;These findings support histology-based prevention, early detection, and treatment strategies.&lt;/p&gt;&lt;/div&gt;</jats:p>

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gastric stage adenocarcinoma gnet survival

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