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Clinical epidemiology of gastric cancer

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Singapore Med J 2014; 55(12): 621-628; http://dx.doi.org/10.11622/smedj.2014174
Clinical epidemiology of gastric cancer

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Ang TL, Fock KM
Correspondence: A/Prof Ang Tiing Leong, tiing_leong_ang@cgh.com.sg

ABSTRACT
Gastric cancer is the second leading cause of cancer-related mortality and the fourth most common cancer globally. There are, however, distinct differences in incidence rates in different geographic regions. While the incidence rate of gastric cancer has been falling, that of gastric cardia cancers is reportedly on the rise in some regions. Helicobacter pylori (H. pylori) infection is a major risk factor of non-cardia gastric cancer, and data has emerged concerning the role of H. pylori eradication for primary prevention of gastric cancer. Dietary, lifestyle and metabolic factors have also been implicated. Although addressing these other factors may contribute to health, the actual impact in terms of cancer prevention is unclear. Once irreversible histological changes have occurred, endoscopic surveillance would be necessary. A molecular classification system offers hope for molecularly tailored, personalised therapies for gastric cancer, which may improve the prognosis for patients.

Keywords: epidemiology, gastric cancer, H. pylori
Singapore Med J 2014; 55(12): 621-628; http://dx.doi.org/10.11622/smedj.2014174

http://smj.org.sg/sites/default/files/5512/5512ra2.pdf

REFERENCES

1. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOSCAN 2008. Int J Cancer 2010; 127:2893-917.
http://dx.doi.org/10.1002/ijc.25516
 
2. Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v2.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Online]. Available: http://globocan.iarc.fr. Accessed June 3, 2014.
 
3. Fock KM, Ang TL. Epidemiology of Helicobacter pylori infection and gastric cancer in Asia. J Gastroenterol Hepatol 2010; 25:479-86.
http://dx.doi.org/10.1111/j.1440-1746.2009.06188.x
 
4. Wong BC, Lm SK, Ching CK, et al. Differential Helicobacter pylori infection rates in two contrasting gastric cancer risk regions of South China. China Gastric Cancer Study Group. J Gastroenterol Hepatol 1999; 14:120-5.
http://dx.doi.org/10.1046/j.1440-1746.1999.01823.x
 
5. Zhang DH, Zhou LY, Lin SR, et al. Recent changes in the prevalence of Helicobacter pylori infection among children and adults in high- or low-incidence regions of gastric cancer in China. Chin Med J (Engl) 2009; 122:1759-63.
 
6. Aragonés N, Pérez-Gómez B, Pollán M, et al. The striking geographical pattern of gastric cancer mortality in Spain: environmental hypotheses revisited. BMC Cancer 2009; 9:316.
http://dx.doi.org/10.1186/1471-2407-9-316
 
7. Mezzanotte G, Cislaghi C, Decarli A, La Vecchia C. Cancer mortality in broad Italian geographical areas, 1975-1977. Tumori 1986; 72:145-52.
PMid:3705187
 
8. Wong BC, Ching CK, Lam SK, et al. Differential north to south gastric cancer-duodenal ulcer gradient in China. China Ulcer Study Group. J Gastroenterol Hepatol 1998; 13:1050-57.
http://dx.doi.org/10.1111/j.1440-1746.1998.tb00569.x
 
9. Arnold M, Razum O, Coebergh JW. Cancer risk diversity in non-western migrants to Europe: An overview of the literature. Eur J Cancer 2010; 46:2647-59.
http://dx.doi.org/10.1016/j.ejca.2010.07.050
 
10. Ronellenfitsch U, Kyobutungi C, Ott JJ, et al. Stomach cancer mortality in two large cohorts of migrants from the Former Soviet Union to Israel and Germany: are there implications for prevention? Eur J Gastroenterol Hepatol 2009; 21:409-16.
http://dx.doi.org/10.1097/MEG.0b013e3283155220
 
11. Nguyen EV. Cancer in Asian American males: epidemiology, causes, prevention, and early detection. Asian Am Pac Isl J Health 2003; 10:86-99.
PMid:15509149
 
12. Maskarinec G, Noh JJ. The effect of migration on cancer incidence among Japanese in Hawaii. Ethn Dis 2004; 14:431-9.
PMid:15328946
 
13. Bertuccio P, Chatenoud L, Levi F, et al. Recent patterns in gastric cancer: a global overview. Int J Cancer 2009; 125:666-73.
http://dx.doi.org/10.1002/ijc.24290
 
14. Matsuda A, Machii R. Trends in stomach cancer mortality rates in Japan, USA, UK, France and Korea based on the WHO mortality database. Jpn J Clin Oncol 2012; 42:154.
http://dx.doi.org/10.1093/jjco/hys004
 
15. Tanaka M, Ma E, Tanaka H, et al. Trends of stomach cancer mortality in Eastern Asia in 1950-2004: comparative study of Japan, Hong Kong and Singapore using age, period and cohort analysis. Int J Cancer 2012; 130:930-6.
http://dx.doi.org/10.1002/ijc.26080
 
16. Anderson WF, Camargo MC, Fraumeni JF Jr, et al. Age-specific trends in incidence of noncardia gastric cancer in US adults. JAMA 2010; 303:1723‑8.
http://dx.doi.org/10.1001/jama.2010.496
 
17. Bray F, Jemal A, Grey N, Ferlay J, Forman D. Global cancer transitions according to the Human Development Index (2008-2030): a population-based study. Lancet Oncol 2012; 13:790-801.
http://dx.doi.org/10.1016/S1470-2045(12)70211-5
 
18. Devesa SS, Blot WJ, Fraumeni JF Jr. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 1998; 83:2049-53.
http://dx.doi.org/10.1002/(SICI)1097-0142(19981115)83:10<2049::AID-CNCR1>3.0.CO;2-2
 
19. Botterweck AA, Schouten LJ, Volovics A, Dorant E, van Den Brandt PA. Trends in incidence of adenocarcinoma of the oesophagus and gastric cardia in ten European countries. Int J Epidemiol 2000; 29:645-54.
http://dx.doi.org/10.1093/ije/29.4.645
 
20. de Martel C, Forman D, Plummer M. Gastric cancer: epidemiology and risk factors. Gastroenterol Clin North Am 2013; 42:219-40.
http://dx.doi.org/10.1016/j.gtc.2013.01.003
 
21. Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 1965; 64:31-49.
PMid:14320675
 
22. Vauhkonen M, Vauhkonen H, Sipponen P. Pathology and molecular biology of gastric cancer. Best Pract Res Clin Gastroenterol 2006; 20:651‑74.
http://dx.doi.org/10.1016/j.bpg.2006.03.016
 
23. Laurén PA, Nevalainen TJ. Epidemiology of intestinal and diffuse types of gastric carcinoma. A time-trend study in Finland with comparison between studies from high- and low-risk areas. Cancer 1993; 71:2926-33.
http://dx.doi.org/10.1002/1097-0142(19930515)71:10<2926::AID-CNCR2820711007>3.0.CO;2-X
 
24. Ikeda Y, Mori M, Kamakura T, et al. Improvements in diagnosis have changed the incidence of histological types in advanced gastric cancer. Br J Cancer 1995; 72:424-6.
http://dx.doi.org/10.1038/bjc.1995.349
 
25. Yu J, Zhao Q. The demographic characteristics of histological types of gastric cancer with gender, age, and tumor location. J Gastrointest Cancer 2009; 40:98-100.
http://dx.doi.org/10.1007/s12029-009-9107-6
 
26. Popiela T, Kulig J, Kołodziejczyk P, Sierzega M. Changing patterns of gastric carcinoma over the past two decades in a single institution: clinicopathological findings in 1557 patients. Scand J Gastroenterol 2002; 37:561-7.
http://dx.doi.org/10.1080/00365520252903116
 
27. Henson DE, Dittus C, Younes M, Nguyen H, Albores-Saavedra J. Differential trends in the intestinal and diffuse types of gastric carcinoma in the United States, 1973-2000: increase in the signet ring cell type. Arch Pathol Lab Med 2004; 128:765-70.
PMid:15214826
 
28. Lundegårdh G, Lindgren A, Rohul A, et al. Intestinal and diffuse types of gastric cancer: secular trends in Sweden since 1951. Br J Cancer 1991; 64:1182-6.
http://dx.doi.org/10.1038/bjc.1991.487
 
29. Kaneko S, Yoshimura T. Time trend analysis of gastric cancer incidence in Japan by histological types, 1975-1989. Br J Cancer 2001; 84:400-5.
http://dx.doi.org/10.1054/bjoc.2000.1602
 
30. Helicobacter and Cancer Collaborative Group. Gastric cancer and Helicobacter pylori: a combined analysis of 12 case control studies nested within prospective cohorts. Gut 2001; 49:347-53.
http://dx.doi.org/10.1136/gut.49.3.347
 
31. Graham DY, Lu H, Yamaoka Y. African, Asian or Indian enigma, the East Asian Helicobacter pylori: facts or medical myths. J Dig Dis 2009; 10:77‑84.
http://dx.doi.org/10.1111/j.1751-2980.2009.00368.x
 
32. Fock KM, Talley N, Moayyedi P, et al. Asia-Pacific consensus guidelines on gastric cancer prevention. J Gastroenterol Hepatol 2008; 23:351-65.
http://dx.doi.org/10.1111/j.1440-1746.2008.05314.x
 
33. Mera R, Fontham ET, Bravo LE, et al. Long term follow up of patients treated for Helicobacter pylori infection. Gut 2005; 54:1536-40.
http://dx.doi.org/10.1136/gut.2005.072009
 
34. Leung WK, Lin SR, Ching JY, et al. Factors predicting progression of gastric intestinal metaplasia: results of a randomized trial on Helicobacter pylori eradication. Gut 2004; 53: 1244-9.
http://dx.doi.org/10.1136/gut.2003.034629
 
35. Lee YC, Chen TH, Chiu HM, et al. The benefit of mass eradication of Helicobacter pylori infection: a community-based study of gastric cancer prevention. Gut 2013; 62:676-82.
http://dx.doi.org/10.1136/gutjnl-2012-302240
 
36. Rokkas T, Pistiolas D, Sechopoulos P, Robotis I, Margantinis G. The long-term impact of Helicobacter pylori eradication on gastric histology: a systematic review and meta-analysis. Helicobacter 2007; 12 Suppl 2:32‑8.
http://dx.doi.org/10.1111/j.1523-5378.2007.00563.x
 
37. Wang J, Xu L, Shi R, et al. Gastric atrophy and intestinal metaplasia before and after Helicobacter pylori eradication: a meta-analysis. Digestion 2011; 83:253-60.
http://dx.doi.org/10.1159/000280318
 
38. Uemura N, Mukai T, Okamoto S, et al. Effect of Helicobacter pylori eradication on subsequent development of cancer after endoscopic resection of early gastric cancer. Cancer Epidemiol Biomarkers Prev 1997; 6:639-42.
PMid:9264278
 
39. Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 2001; 345:784-9.
http://dx.doi.org/10.1056/NEJMoa001999
 
40. You WC, Brown LM, Zhang L, et al. Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions. J Natl Cancer Inst 2006; 98:974-83.
http://dx.doi.org/10.1093/jnci/djj264
 
41. Zhou LY, Lin SR, Ding SG, et al. The changing trends of the incidence of gastric cancer after Helicobacter pylori eradication in Shandong area. Chin J Dig Dis 2005; 6:114-5.
http://dx.doi.org/10.1111/j.1443-9573.2005.00204.x
 
42. Wong BC, Lam SK, Wong WM, et al. Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial. JAMA 2004; 291:187-94.
http://dx.doi.org/10.1001/jama.291.2.187
 
43. Saito D, Boku N, Fujioka T, et al. Impact of H. pylori eradication on gastric cancer prevention: endoscopic results of the Japanese Intervention Trial (JITHP-Study). A Randomized Multi-Center Trial. Gastroenterology 2005; 128 Suppl 2:A4.
 
44. Kato M, Asaka M. Eradication of Helicobacter pylori for the incidence of metachronous gastric cancer after endoscopic resection. J Gastroenterol Hepatol 2007; 22:A64.
 
45. Sato T, Fukuyama T, Suzuki T, et al. Studies of causation of gastric cancer 2. The relation between gastric cancer mortality rate and salted food intake in several places in Japan. Bull Inst Public Health 1959; 8:187-98.
 
46. Wang XQ, Terry PD, Yan H. Review of salt consumption and stomach cancer risk: epidemiological and biological evidence. World J Gastroenterol 2009; 15:2204-13.
http://dx.doi.org/10.3748/wjg.15.2204
 
47. Joossens JV, Hill MJ, Elliott P, et al. Dietary salt, nitrate and stomach cancer mortality in 24 countries. European Cancer Prevention (ECP) and the INTERSALT Cooperative Research Group. Int J Epidemiol 1996; 25:494‑504.
http://dx.doi.org/10.1093/ije/25.3.494
 
48. D'Elia L, Rossi G, Ippolito R, Cappuccio FP, Strazzullo P. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr 2012; 31:489-98.
http://dx.doi.org/10.1016/j.clnu.2012.01.003
 
49. Ren JS, Kamangar F, Forman D, Islami F. Pickled food and risk of gastric cancer--a systematic review and meta-analysis of English and Chinese literature. Cancer Epidemiol Biomarkers Prev 2012; 21:905-15.
http://dx.doi.org/10.1158/1055-9965.EPI-12-0202
 
50. Lunet N, Lacerda-Vieira A, Barros H. Fruit and vegetables consumption and gastric cancer: a systematic review and meta-analysis of cohort studies. Nutr Cancer 2005; 53:1-10.
http://dx.doi.org/10.1207/s15327914nc5301_1
 
51. Bertuccio P, Rosato V, Andreano A, et al. Dietary patterns and gastric cancer risk: a systematic review and meta-analysis. Ann Oncol 2013; 24:1450-8.
http://dx.doi.org/10.1093/annonc/mdt108
 
52. Boehm K, Borrelli F, Ernst E, et al. Green tea (Camellia sinensis) for the prevention of cancer. Cochrane Database Syst Rev 2009; 3:CD005004.
PMid:19588362
 
53. Sasazuki S, Tamakoshi A, Matsuo K, et al. Green tea consumption and gastric cancer risk: an evaluation based on a systematic review of epidemiologic evidence among the Japanese population. Jpn J Clin Oncol 2012; 42:335-46.
http://dx.doi.org/10.1093/jjco/hys009
 
54. Ladeiras-Lopes R, Pereira AK, Nogueira A, et al. Smoking and gastric cancer: systematic review and meta-analysis of cohort studies. Cancer Causes Control 2008; 19:689-701.
http://dx.doi.org/10.1007/s10552-008-9132-y
 
55. Shimazu T, Tsuji I, Inoue M, et al. Alcohol drinking and gastric cancer risk: an evaluation based on a systematic review of epidemiologic evidence among the Japanese population. Jpn J Clin Oncol 2008; 38:8-25.
http://dx.doi.org/10.1093/jjco/hym152
 
56. Asano K, Kubo M, Yonemoto K, et al. Impact of serum total cholesterol on the incidence of gastric cancer in a population-based prospective study: the Hisayama study. Int J Cancer 2008; 122:909-14.
http://dx.doi.org/10.1002/ijc.23191
 
57. Stemmermann GN, Chyou PH, Kagan A, Nomura AM, Yano K. Serum cholesterol and mortality among Japanese-American men. The Honolulu (Hawaii) Heart Program. Arch Intern Med 1991; 151:969-72.
http://dx.doi.org/10.1001/archinte.1991.00400050113021
 
58. Eichholzer M, Stähelin HB, Gutzwiller F, Lüdin E, Bernasconi F. Association of low plasma cholesterol with mortality for cancer at various sites in men: 17-y follow-up of the prospective Basel study. Am J Clin Nutr 2000; 71:569-74.
PMid:10648273
 
59. Iso H, Ikeda A, Inoue M, Sato S, Tsugane S. Serum cholesterol levels in relation to the incidence of cancer: the JPHC study cohorts. Int J Cancer 2009; 125:2679-86.
http://dx.doi.org/10.1002/ijc.24668
 
60. Hu J, La Vecchia C, de Groh M, et al. Dietary cholesterol intake and cancer. Ann Oncol 2012; 23:491-500.
http://dx.doi.org/10.1093/annonc/mdr155
 
61. Jung MK, Jeon SW, Cho CM, et al. Hyperglycaemia, hypercholesterolemia and the risk for developing gastric dysplasia. Dig Liver Dis 2008; 40:361‑5.
http://dx.doi.org/10.1016/j.dld.2007.12.002
 
62. Ikeda F, Doi Y, Yonemoto K, et al. Hyperglycemia increases risk of gastric cancer posed by Helicobacter pylori infection: a population-based cohort study. Gastroenterology 2009; 136:1234-41.
http://dx.doi.org/10.1053/j.gastro.2008.12.045
 
63. Kim HY. Metabolic syndrome is associated with gastric dysplasia. Eur J Gastroenterol Hepatol 2011; 23:871-5.
http://dx.doi.org/10.1097/MEG.0b013e328349aa18
 
64. Wu XD, Zeng K, Xue FQ, Chen JH, Chen YQ. Statins are associated with reduced risk of gastric cancer: a meta-analysis. Eur J Clin Pharmacol 2013; 69:1855-60.
http://dx.doi.org/10.1007/s00228-013-1547-z
 
65. Yang P, Zhou Y, Chen B, et al. Overweight, obesity and gastric cancer risk: results from a meta-analysis of cohort studies. Eur J Cancer 2009; 45:2867-73.
http://dx.doi.org/10.1016/j.ejca.2009.04.019
 
66. Sjodahl K, Jia C, Vatten L, et al. Body mass and physical activity and risk of gastric cancer in a population-based cohort study in Norway. Cancer Epidemiol Biomarkers Prev 2008; 17:135-40.
http://dx.doi.org/10.1158/1055-9965.EPI-07-0704
 
67. Kuriyama S, Tsubono Y, Hozawa A, et al. Obesity and risk of cancer in Japan. Int J Cancer 2005; 113:148-57.
http://dx.doi.org/10.1002/ijc.20529
 
68. El-Omar EM, Oien K, Murray LS, et al. Increased prevalence of precancerous changes in relatives of gastric cancer patients: critical role of H. pylori. Gastroenterology 2000; 118:22-30.
http://dx.doi.org/10.1016/S0016-5085(00)70410-0
 
69. Brenner H, Arndt V, Stürmer T, et al. Individual and joint contribution of family history and Helicobacter pylori infection to the risk of gastric carcinoma. Cancer 2000; 88:274-9.
http://dx.doi.org/10.1002/(SICI)1097-0142(20000115)88:2<274::AID-CNCR5>3.0.CO;2-9
 
70. Seevaratnam R, Coburn N, Cardoso R, et al. A systematic review of the indications for genetic testing and prophylactic gastrectomy among patients with hereditary diffuse gastric cancer. Gastric Cancer 2012; 15 Suppl 1:S153-63.
http://dx.doi.org/10.1007/s10120-011-0116-3
 
71. El-Omar EM, Carrington M, Chow WH, et al. Interleukin-1 polymorphisms associated with increased risk of gastric cancer. Nature 2000; 404:398-402.
http://dx.doi.org/10.1038/35006081
 
72. Persson C, Canedo P, Machado JC, El-Omar EM, Forman D. Polymorphisms in inflammatory response genes and their association with gastric cancer: A HuGE systematic review and meta-analyses. Am J Epidemiol 2011; 173:259-70.
http://dx.doi.org/10.1093/aje/kwq370
 
73. Lei Z, Tan IB, Das K, et al. Identification of molecular subtypes of gastric cancer with different responses to PI3-kinase inhibitors and 5-fluorouracil. Gastroenterology 2013; 145:554-65.
http://dx.doi.org/10.1053/j.gastro.2013.05.010
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