Young White Americans Experience Higher Rate of Stomach Cancer
There appears to be an increase in the rate of stomach cancer in young white adults even as the incidence of stomach cancer has fallen for all other American adults.
Charles S. Rabkin, MD, of the National Cancer Institute, and colleagues reported in the May 5 issue of the Journal of the American Medical Association the small but significant increase in the incidence of cases in lower portions of the stomach, not adjoining the esophagus, experienced over the last 30 years by those ages 25 to 49.
Gastric cancer is the fourth most common type of cancer and the second most common among cancer deaths worldwide.
Stomach cancers of the upper stomach near the esophagus (the cardia) may be related to gastroesophageal reflux. This is not the case for the lower (noncardia) stomach cancers. These noncardia stomach cancers are attributable to chronic mucosal infection by the bacterium Helicobacter pylori and nutritional exposures.
Nutritional exposures which increase the risk of stomach cancer include the consumption of salt and salt-preserved foods. Consumption of fresh fruits and vegetables are protective and can decrease the risk of stomach cancer.
The researchers examined new cases of stomach cancer from 1977 to 2006 of cancer. There were 83,225 adults with primary gastric cancer, including 39,003 noncardia cases.
The researchers found that over the last 50 years the incidence of noncardia gastric cancer has steadily declined in most populations. Age-standardized annual incidence per 100,000 population declined from 5.9 to 4.0 in whites, from 13.7 to 9.5 in blacks, and from 17.8 to 11.7 in other races.
The exception was found with an increase among whites, ages 25 to 39. This group had an increase from 0.27 per 100,000 to 0.45 even while the whites ages 40 to 59 decreased from 2.6 to 2.0 and those ages 60 to 84 from 19.8 to 12.8.
Gastric cancer is a complex disease to treat, but the best option for treating gastric cancer is surgery plus adjuvant chemotherapy.
Anderson WF, et al "Age-specific trends in incidence of noncardia gastric cancer in U.S. adults" JAMA 2010; 303(17): 1723-28.
Paoletti X, et al "Benefit of adjuvant chemotherapy for resectable gastric cancer" JAMA 2010; 303(17): 1729-37.