OBJECTIVE : There are remarkable differences between the incidence and mortality of gastric cancer in different places of the world. This study, for the first time, estimated the information around the incidence rates and trends of gastric cancer in the central area of Iran, Arak metropolitan. METHODS : In this study, all cases with gastric cancer in Arak from 2009 to 2014 were included. Direct standardized method was applied to estimate age-standardized incidence rates (ASIRs) by a STATA package, with efficient interval estimation that might be preferable in the case of rare diseases, including cancer data. The obtained standard errors were used to calculate annual percent changes (APCs) by the Joinpoint analysis. RESULTS : Annual ASIRs of gastric cancer were 23.92 (95% CI 21.62, 26.37) and 9.60 (95% CI 8.20, 11.18) for male and female, respectively. In male, APC of ASIRs was - 5.00% (95% CI - 9.32, - 0.47). In contrast, among female, it was - 2.69% (95% CI - 31.56, 38.34) that was statistically insignificant. CONCLUSIONS : The ASIRs have significantly decreased trends in males, but not in females. The preventive strategies should be a focus on the declining of the risk factors and the quick early diagnosis of gastric cancer.