Stomach cancer is the fourth most common cancer globally, with an estimate of new cases just short of 1 million in 2008.1, 2 The prognosis for stomach cancer is generally poor, as patients are often diagnosed late and at quite advanced stages.1 Stomach cancer is largely attributed to environmental causes.1, 3 The main risk factor is infection with Helicobacter pylori (H. pylori) which can cause inflammation of the gastric muscosa; however, only a small proportion of people with H. pylori will develop cancer.4-6
History of stomach cancer in first-degree relatives can double or triple the risk, depending on the number of relatives with the disease.7, 8 There is probable evidence to support the decrease in stomach cancer risk with the consumption of non-starchy vegetables, allium vegetables and fruits.9 On the other hand, excessive consumption of salted fish, pickled vegetables, cured meats and soy sauce is associated with increasing risk.5, 10 Additional lifestyle influences on stomach cancer include the consumption of alcohol and tobacco as well as heavy long-term asbestos exposure, X- and γ-radiation exposure or working in rubber manufacturing. 5, 11-15
Our analysis showed a decrease in incidence and mortality for both males and females. There was a 50% decrease in mortality and a 34% decrease in incidence, both of which are statistically significant. The observed falls reflect improvements in living standards from the 1920s, when the prevalence of H. pylori began to fall.1, 16
Prevention strategies are the best hope of continuing the trend of declining incidence and mortality associated with stomach cancer.17 Prevention initiatives for stomach cancer revolve around dietary controls and reducing the possibility of H. pylori infection.1, 18 Promoting positive dietary habits could reduce the burden of stomach cancer by approximately 50%.10, 16
Stomach cancer deaths and incident cases in Australia 1987–2007
|Deaths +||Incident Cases +|
|Observed in 2007 (O)#||368||203||572||765||365||1,131|
|Expected in 2007 (E) §||809||340||1,149||1,201||508||1,709|
|Change (O-E)/E (%)||-54||-40||-50||-36||-28||-34|
#An average of the observed rates for 2006 to 2008 was applied to the 2007 population of Australians aged 74 and under to calculate the observed number of deaths and incident cases for 2007.
§An average of the observed rates for 1986 to 1988 was applied to the 2007 population of Australians aged 74 and under to calculate the expected number of deaths and incident cases for 2007.
+All figures have been rounded to the nearest whole number.
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- World Cancer Research Fund / American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington, DC: American Institute for Cancer Research; 2007
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