Stomach Cancer Rate by Country: Regional Patterns and Risks

Stomach cancer remains a significant global health concern, with incidence rates varying widely between countries due to genetics, diet, infection rates, and healthcare access. Understanding where stomach cancer is most common—and why—can help inform prevention strategies and public health policies.

Global Incidence Patterns

Stomach cancer incidence varies significantly worldwide. According to Global Cancer Observatory (GLOBOCAN) data from the International Agency for Research on Cancer (IARC), the highest rates are observed in East Asia, Eastern Europe, and parts of South America, while much lower rates are found in North America, Africa, and certain regions of Western Europe. These disparities result from environmental exposures, genetic predispositions, and healthcare interventions that influence disease development and detection.

Countries such as Mongolia, Japan, and South Korea report age-standardized rates exceeding 30 cases per 100,000 individuals annually, while nations like the United States, Canada, and most of sub-Saharan Africa report rates below 10 per 100,000. Regional factors, including dietary habits, infection prevalence, and healthcare infrastructure, significantly impact disease burden. For instance, Japan and South Korea have long-standing screening programs that improve detection rates, but their diets, rich in salt-preserved foods, contribute to higher gastric cancer risk.

Over the past few decades, many high-income countries have seen a steady decline in cases due to improved food preservation, reduced Helicobacter pylori infection rates, and increased awareness of risk factors. In contrast, some low- and middle-income nations face stable or rising incidence rates due to persistent exposure to carcinogens and limited access to early detection programs. In parts of Latin America, such as Chile and Costa Rica, stomach cancer remains a leading cause of cancer-related mortality despite medical advancements.

Highest-Risk Regions

Stomach cancer rates are disproportionately high in East Asia, Eastern Europe, and parts of South America. East Asia has the highest burden, with Mongolia leading at over 32 cases per 100,000 individuals annually, followed by Japan and South Korea, where rates surpass 30 per 100,000. These figures reflect dietary customs, infection prevalence, and genetic susceptibility.

In Japan and South Korea, widespread consumption of salt-preserved foods, such as pickled vegetables and salted fish, significantly increases gastric cancer risk. Excessive salt can damage the stomach lining and enhance the carcinogenic effects of H. pylori infection. A large-scale cohort study in The Lancet Oncology found that individuals with high dietary salt intake had more than twice the risk of developing stomach cancer compared to those with lower consumption. Robust screening programs in these countries also contribute to higher detection rates.

Eastern Europe also experiences a high burden, particularly in Russia, Ukraine, and Belarus, where incidence ranges between 15 and 25 cases per 100,000 annually. Factors include diets rich in smoked and processed meats, low fresh produce consumption, and historically high H. pylori infection rates. A study in Cancer Epidemiology, Biomarkers & Prevention reported that Eastern European populations have some of the highest H. pylori prevalence rates, exacerbating gastric cancer incidence. Additionally, high alcohol and tobacco use further increase risk.

In South America, Chile and Costa Rica report some of the highest stomach cancer rates outside Asia. Chile’s incidence exceeds 20 per 100,000, making it a leading cause of cancer-related mortality. Indigenous populations in the region may have genetic polymorphisms that increase susceptibility, particularly in the presence of chronic H. pylori infection. Dietary habits, including smoked and salted meats, also contribute. Research in Gastric Cancer suggests that nitrate exposure in drinking water, particularly in agricultural areas, may further elevate risk.

Lowest-Risk Regions

Stomach cancer remains relatively uncommon in North America, sub-Saharan Africa, and parts of Western Europe. In the United States and Canada, age-standardized rates typically fall below 10 cases per 100,000, a stark contrast to high-incidence countries. Reduced consumption of salt-preserved foods, widespread refrigeration, and lower H. pylori infection rates have contributed to this decline.

Western Europe, particularly Denmark, Sweden, and the Netherlands, reports some of the lowest stomach cancer rates globally, ranging between 5 and 8 cases per 100,000. Public health initiatives promoting balanced diets rich in fresh produce, lean proteins, and whole grains likely help reduce risk. Access to high-quality medical care enables early detection and management of precancerous conditions. The shift from traditional food preservation methods like smoking and salting to refrigeration has also lowered exposure to dietary carcinogens.

Sub-Saharan Africa presents a unique case, with some of the lowest stomach cancer rates despite limited healthcare access. Countries such as Nigeria, Ethiopia, and Ghana report incidence rates below 5 per 100,000. While underreporting and diagnostic limitations may play a role, traditional African diets rich in fiber, legumes, and minimally processed plant foods may offer protection. Additionally, lower prevalence of H. pylori infection in these populations could contribute to reduced incidence.

Helicobacter Pylori Prevalence Across Populations

H. pylori is one of the most widespread bacterial infections globally, with prevalence rates varying significantly by region. This bacterium colonizes the stomach lining and is a major risk factor for gastric cancer. Estimates suggest that over 50% of the global population harbors H. pylori, though prevalence ranges from over 80% in some developing nations to below 40% in high-income countries. Socioeconomic conditions, sanitation standards, and household transmission patterns drive these differences.

In areas with poor sanitation and overcrowding, early-life H. pylori acquisition is common, often occurring in childhood through household contact or contaminated water. In parts of Africa, South Asia, and Latin America, the bacterium is frequently detected in young children. In contrast, industrialized nations have seen a steady decline in H. pylori prevalence due to improved hygiene, antibiotic use, and better access to clean water. In countries like the United States and Sweden, younger generations have significantly lower infection rates than older adults, reflecting public health improvements.

Dietary And Lifestyle Influences

Regional variations in stomach cancer rates are closely linked to diet and lifestyle. Certain foods and preparation methods increase risk, while others may be protective. High consumption of salt-preserved foods, such as pickled vegetables, salted fish, and processed meats, has been consistently associated with higher incidence, particularly in East Asian and Eastern European populations. Excessive salt intake damages the stomach lining and enhances H. pylori’s carcinogenic effects. A meta-analysis in Gastroenterology found that individuals with high dietary salt intake had a 68% greater risk of developing gastric cancer.

Diets rich in fresh fruits and vegetables, particularly those high in antioxidants like vitamin C and beta-carotene, are linked to lower stomach cancer risk. These nutrients help neutralize reactive oxygen species and reduce oxidative stress, which can contribute to gastric mucosal damage and carcinogenesis. Mediterranean diets, which emphasize olive oil, fresh produce, and whole grains, are associated with lower stomach cancer rates.

Smoking and heavy alcohol consumption significantly elevate risk. Tobacco smoke introduces carcinogenic compounds that damage stomach cells, while chronic alcohol use increases mucosal irritation and susceptibility to carcinogens. A large cohort study in The BMJ found that smokers had nearly double the risk of developing stomach cancer compared to non-smokers, reinforcing the importance of smoking cessation in prevention efforts.

Mortality And Survival Variations

Survival outcomes vary widely based on healthcare access, early detection, and treatment availability. In high-incidence countries like Japan and South Korea, national screening programs lead to earlier diagnoses and better survival rates. Japan’s five-year survival rate exceeds 60% due to widespread endoscopic screening that detects tumors before they progress. In contrast, in countries where screening is less common, such as parts of Eastern Europe and Latin America, late-stage diagnoses result in poorer prognoses. Russia’s five-year survival rate hovers around 25%, reflecting challenges in early detection and treatment access.

Treatment disparities further impact survival. In nations with advanced healthcare infrastructure, access to minimally invasive surgery, targeted therapies, and immunotherapy has improved outcomes. Treatments such as trastuzumab for HER2-positive gastric cancer and immune checkpoint inhibitors have extended survival in high-income countries. Meanwhile, in resource-limited settings, treatment options remain constrained, and late-stage diagnosis often necessitates palliative rather than curative care. Expanding early detection programs, improving treatment access, and addressing known risk factors could help reduce global stomach cancer mortality.