OBJECTIVES: The objective of this study was to assess current global burden of GC and GEJC, and differences across regions.

METHODS: A targeted literature review of the epidemiology, current management, and the economic and humanistic burdens of GC and GEJC worldwide was conducted using PubMed, Cochrane and EconLit databases. Searches were limited to the last 15 years with no geographic restrictions.

RESULTS: Ninety-five records were selected for review from a total of 8,148 unique identified records, focused on: epidemiology (19), management (16), economic (17), humanistic (27) and multiple topics (16). Data from identified records showed significant differences in GC epidemiology across countries, with world age-standardized incidence per 100,000 in 2012 ranging from 0.9 to 41.8. No global epidemiology data for GEJC alone was identified; GC incidence rates include most GEJC cases. Review of most recent clinical guidelines revealed a large number of chemotherapy regimens available for advanced disease but recommendations vary across regions. Median overall survival for a patient with advanced or metastatic GC or GEJC is 6-14 months, rarely exceeding 10 months. Patients with early GC or GEJC have either no symptoms or non-specific symptoms leading to many patients not being diagnosed until the advanced stages, particularly in low-incidence countries. Disease progression is associated with increased symptom-burden and drastic health-related quality of life deterioration. Disease progression is also associated with an increase in the economic burden. Average healthcare related cost per patient ranged from (2017 values) $75,617 to $136,350 in high-income countries.

CONCLUSIONS: GC and GEJC are diseases with marked epidemiological differences across the globe, characterized by high humanistic and economic burden at advanced stages. Median overall survival is dismal in the patients with advanced disease regardless of region or treatment.