A modelling study has found that absolute gastric cancer cases in New Zealand are projected to increase, particularly in Māori and Pacific peoples and in regions experiencing rapid population growth. The New Zealand Cancer Registry was used to identify gastric cancer registrations from 2001 to 2022 and link these to population estimates and projections. By 2045, gastric cancer cases were predicted to reach approximately 725 per year, a 47.7% increase on current numbers, despite the age-standardised rate decreasing from 5.9 to 5.3 per 100,000. Increased absolute numbers were seen for all regions, with the Northern Region showing the largest rise. By ethnic group, the highest current incidence and proportional increase in projected cases was seen for Māori and Pacific peoples, although there was a modest decline in incidence rates for all ethnic groups.