Stomach cancer (C16)

stomachStomach 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

Risk_factors_stomachOur 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

stomach_graph

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 +
Male Female Persons Male Female Persons
Observed in 2007 (O) 368 203 572 765 365 1,131
Expected in 2007 (E) § 809 340 1,149 1,201 508 1,709
Difference (O-E)  -441 -137 -577 -436 -143 -578
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.


 Download this chapter of the Report - 7.8: Stomach Cancer (890Kb)


References:

  1. Boyle P, Levin B, editors. World Cancer Report 2008. Geneva: IARC; 2008.
  2. Ferlay J, Shin H, Bray F, Forman D, Mathers C, Parkin D. GLOBOCAN 2008 v2.0, Cancer incidence and mortality worldwide: IARC CancerBase No. 10: Lyon, France: IARC, 2010.
  3. Kelley JR, Duggan JM. Gastric cancer epidemiology and risk factors. J Clin Epidemiol. 2003;56 (1):1-9.
  4. Compare D, Rocco A, Nardone G. Risk factors in gastric cancer. Eur Rev Med Pharmacol Sci. 2010;14 (4):302-8.
  5. Nagini S. Carcinoma of the stomach: A review of epidemiology, pathogenesis, molecular genetics and chemoprevention. World J Gastro Oncol. 2012;4 (7):156-69.
  6. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. IARC Monographs: Biological Agents. Volume 100B A review of human carcinogens. Lyon: IARC; 2012
  7. Catalano V, Labianca R, Beretta G, Gatta G, de Braud F, Van Cutsem E. Gastric cancer. Crit Rev Oncol Hematol. 2009;71 (2):127-64.
  8. Dhillon P, Farrow D, Vaughan T, Chow W, Risch H, Gammon M, Mayne S, Stanford J, Schoenberg J, Ahsan H, Dubrow R, West A, et al. Family history of cancer and risk of esophageal and gastric cancers in the United States. Int J Cancer. 2001;93 (1):148-52.
  9. 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
  10. Wang X-Q, Terry P-D, Yan H. Review of salt consumption and stomach cancer risk: epidemiological and biological evidence. World J Gastroenterol. 2009;15 (18):2204-13.
  11. Bonequi P, Meneses-González F, Correa P, Rabkin C, Camargo M. Risk factors for gastric cancer in Latin America: a meta-analysis. Cancer Causes Control. 2013;24 (2):217-31.
  12. Pichandi S, Pasupathi P, Rao Y, Farook J, Ponnusha B, Ambika A, Subramaniyam S. The effect of smoking on cancer-a review. Int J Biol Med Res. 2011;2 (2):593-602.
  13. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. IARC Monographs: Arsenic, Metals, Fibres and Dusts. Volume 100C A review of human carcinogens. Lyon: IARC; 2012
  14. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. IARC Monographs: Radiation. Volume 100D A review of human carcinogens. Lyon: IARC; 2012
  15. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. IARC Monographs: Chemical agents and related occupations. Volume 100F A review of human carcinogens. Lyon: IARC; 2012
  16. Roder D. The epidemiology of gastric cancer. Gastric Cancer. 2002;5 (Suppl 1):5-11.
  17. Correa P, Piazuelo M, Camargo M. The future of gastric cancer prevention. Gastric Cancer. 2004;7 (1):9-16.
  18. Giordano A, Cito L. Advances in gastric cancer prevention. World J Clin Oncol. 2012;3 (9):128-36.

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