Current Medical Science · Oct 26, 2026

Ambient Air Pollution and Gastric Cancer Incidence: A Multinational Ecological Analysis (1990-2020)

By Li XH, Zhang F, Wang J et al.

OBJECTIVE: While ambient air pollution constitutes a major global health risk, its long-term association with gastric cancer burden at a global scale, especially its impact on vulnerable populations, remains poorly characterized. We examined the association between long-term exposure to ambient air pollution and gastric cancer incidence. METHODS: In this ecological study, we analyzed data from 204 countries (1990-2020) from the Global Burden of Disease 2021 study. We examined the association between age-standardized incidence rates of gastric cancer and long-term exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO₂), and ozone (O₃). We used adjusted negative binomial fixed-effects panel regression, natural cubic splines for nonlinearity, stratified analyses by sex, age, and sociodemographic index (SDI), and lag models. RESULTS: Significant positive associations were found. Each one-unit increase in PM2.5, NO₂, and O₃ was associated with 0.3% (95% CI: 0.1-0.5%), 1.8% (1.2-2.4%), and 0.6% (0.3-0.9%) increases in overall incidence, respectively, at the population level. The exposure‒response relationships were nonlinear, with critical lag windows of 3-4 years for PM2.5 and 3 years for O₃. Stratified analyses revealed greater male susceptibility to PM2.5, whereas females were more vulnerable to NO₂ and O₃. High-middle-SDI regions had the highest PM2.5 risk, whereas low-middle-SDI regions were most affected by NO₂ and O₃. Adults aged ≥70 years face the highest risk, with females showing elevated susceptibility after age 60. CONCLUSION: These ecological findings highlight the importance of considering air pollution in gastric cancer prevention frameworks, although the results must be validated by individual-level studies across diverse settings before causal inferences can be drawn.

doi.org/10.1007/s11596-026-00255-zPubMed 42932133Populations