Divergent trends for gastric cancer incidence by anatomical subsite in US adults

Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20852, USA.
Gut (Impact Factor: 14.66). 05/2011; 60(12):1644-9. DOI: 10.1136/gut.2010.236737
Source: PubMed


Age-specific analyses of non-cardia gastric cancer incidence reveal divergent trends among US whites: rates are declining in individuals aged 40 years and older but rising in younger persons. To investigate this heterogeneity further, incidence trends were evaluated by anatomical subsite.
Gastric cancer incidence data for 1976-2007 were obtained from the US National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program and the US Centers for Disease Control and Prevention's National Program of Cancer Registries (NPCR). Incidence rates and estimated annual percentage change were calculated by age group (25-39, 40-59 and 60-84 years), race/ethnicity and subsite.
Based on data from the nine oldest SEER registries (covering ~10% of the US population), rates for all non-cardia subsites decreased in whites and blacks, except for corpus cancer, which increased between 1976 and 2007 with estimated annual percentage changes of 1.0% (95% CI 0.1% to 1.9%) for whites and 3.5% (95% CI 1.8% to 5.2%) for blacks. In contrast, rates for all non-cardia subsites including corpus cancer declined among other races. In combined data from NPCR and SEER registries (covering 89% of the US population), corpus cancer significantly increased between 1999 and 2007 among younger and middle-aged whites; in ethnic-specific analyses, rates significantly increased among the same age groups in non-Hispanic whites and were stable among Hispanic whites. Age-specific rates for all subsites declined or were stable in this period among blacks and other races.
Long- and short-term incidence trends for gastric cancers indicate a shifting distribution by anatomical subsite. Corpus cancer may have distinctive aetiology and changing risk factor exposures, warranting further investigation.

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Available from: M. Constanza Camargo, Apr 04, 2014
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    • "However, our analysis shows that our country has not yet reached the plateau that some other high-income countries are experiencing (Malvezzi et al., 2010; Ferro et al., 2014). In these settings, a shift toward a higher proportion of gastric cardia cancer compared with noncardia (Steevens et al., 2010; Camargo et al., 2011; Ferro et al., 2014) as well as the diffuse histological type (Kaneko and Yoshimura, 2001; Wu et al., 2009) has been observed. The worse prognosis associated with these types of tumors (Bouvier et al., 2010) suggests that further declines in gastric cancer mortality rates may require more intensive prevention and control efforts, but the lack of robust subsite-specific data precludes the identification of such a pattern in Portugal (Castro et al., 2014). "
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    • "The burden of gastric cancer remains very high in several countries from Asia, Latin America and Central and Eastern Europe, whereas in North America and in most Western European countries it is no longer a common cancer [1] [3] [6]. Incidence rates showed differences according to tumour topography [7] [8], with upward trends in cardia incidence [9] [10]. The validity of data on gastric cancer subtypes is, however, open to discussion [11]. "
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