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From 1990 to 2021, the estimated annual percentage change (EAPC) was calculated to clarify the temporal trends in the ASMR and ASDR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Globally, smoking was responsible for 107,926 (95% UI: 84,603\u2013138,448) deaths from GC in 2021, whereas high sodium intake was associated with 75,661 (95% UI: 0-372,194) deaths. From 1990 to 2021, the number of deaths and DALYs due to GC caused by smoking and a high-sodium diet tended to decrease, with the ASMRs and ASDRs also decreasing. Across all periods and regions, the number of deaths, DALYs, ASMRs, and ASDRs related to smoking and a high-sodium diet were greater in males than in females. East Asia, particularly China, had the highest burden. High- and high-middle-SDI regions experienced decreases, while other regions saw increases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite the global decline in the ASMRs and ASDRs of GC attributable to smoking and a high-sodium diet, the absolute number of gastric cancer deaths caused by a high-sodium diet continues to increase because of population growth and ageing, and significant regional differences persist across age groups and regions. Through a comprehensive analysis on a global scale, this study identified the main modifiable risk factors, providing data support and a theoretical basis for the formulation of risk attribution, stratification, and prevention strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-025-04431-8","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T12:55:50Z","timestamp":1764766550000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Global, regional, and national burden of gastric cancer attributable to smoking and a high-sodium diet from 1990 to 2021: a global burden of disease study 2021"],"prefix":"10.1186","volume":"26","author":[{"given":"Guangying","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haojie","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongjian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang","family":"Shang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leping","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"issue":"16","key":"4431_CR1","doi-asserted-by":"publisher","first-page":"2452","DOI":"10.3748\/wjg.v29.i16.2452","volume":"29","author":"WJ Yang","year":"2023","unstructured":"Yang WJ, Zhao HP, Yu Y, Wang JH, Guo L, Liu JY, et al. 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