SciELO - Scientific Electronic Library Online

vol.20 issue3Changing epidemics author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links

  • Have no similar articlesSimilars in SciELO


Arquivos de Medicina

On-line version ISSN 2183-2447

Arq Med vol.20 no.3 Porto May 2006


Gastric Cancer: Frequency and Trends

Nuno Lunet

Serviço de Higiene e Epidemiologia, Faculdade de Medicina da Universidade do Porto


A continued international decline in gastric cancer mortality is one of the most remarkable events in cancer epidemiology. This "unplanned triumph", however, is characterized by geographical differences in cancer frequency and trends, both between and within countries. The declining incidence of gastric carcinoma could be explained primarily by the decrease in the relative number of intestinal type cases, and the cancers of the cardia show increasing or stable trends. The understanding of the site and histological type specific trends in each region, overcoming the methodological difficulties and the gaps in our knowledge of cancer aetiology, are essential to predict the future burden of gastric cancer.

Key-words: stomach neoplasms; cardia; histological type; trends.


Cancro Gástrico: Frequência e Respectiva Evolução

A diminuição continuada da mortalidade por cancro do estômago e um facto singular na epidemiologia do cancro. Este “triunfo não planeado” caracteriza-se por diferenças geográficas nas taxas de incidência e mortalidade e na respectiva evolução nas últimas décadas. Adicionalmente, o declínio na incidência do carcinoma gástrico pode ser explicado primariamente pela diminuição da frequência relativa dos cancros do tipo intestinal e os cancros localizados no cárdia parecem estar a tornar-se mais frequentes. A compreensão da evolução da incidência e mortalidade por cancro gástrico, em cada região, distinguindo localizações anatómicas e tipos histológicos, ultrapassando as dificuldades metodológicas e as lacunas que persistem na forma como actualmente entendemos as suas causas, são essenciais para prever a futura carga de doença e mortalidade associadas ao cancro do estômago.

Palavras-chave: cancro do estômago; cardia; tipo histológico; tendência.



Texto completo disponível apenas em PDF.

Full text only available in PDF format.




1 -Lilienfeld AM, Levin ML, Kessler II. Cancer in the United States. Vital and Health Statistics Monographs. Cambridge: Harvard University Press; 1972.         [ Links ]

2 -Levi F, Lucchini F, Gonzalez JR, Fernandez E, Negri E, La Vecchia C. Monitoring falls in gastric cancer mortality in Europe. Ann Oncol 2004;15:338-45.

3 -Coleman MP, Esteve J, Damiecki P, Arslan A, Renard H. Trends in cancer incidence and mortality. IARC Sci Publ No. 121. Lyon: IARC; 1993.

4 -Aragones N, Pollan M, Rodero I, Lopez-Abente G. Gastric cancer in the European Union (1968-1992): mortality trends and cohort effect. Ann Epidemiol 1997;7:294-303.

5 -World Health Statistics Annual [database on the Internet]. World Health Organization databank. Geneva [updated 2004 December; cited 2004 January 4]. Available from:

6 -Tovar-Guzman V, Hernandez-Giron C, Barquera S, Rodriguez-Salgado N, Lopez-Carrillo L. Epidemiologic panorama of stomach cancer mortality in Mexico. Arch Med Res 2001;32:312-7.

7 -Ferlay J, Bray F, Pisani P, Parkin DM. GLOBOCAN 2002: Cancer Incidence, Mortality and Prevalence Worldwide. IARC CancerBase No. 5, Version 2.0. Lyon: IARCPress; 2004.

8 -Sipponen P, Correa P. Delayed rise in incidence of gastric cancer in females results in unique sex ratio (M/F) pattern: etiologic hypothesis. Gastric Cancer 2002;5:213-9.

9 -Correa P, Haenszel W, Cuello C, Archer M, Tannenbaum S. A model for gastric cancer epidemiology. Lancet1975;II:58-60.

10 -Antonioli DA, Goldman H. Changes in the location and type of gastric adenocarcinoma. Cancer 1982;50:775-81.

11 -Rios-Castellanos E, Sitas F, Shepherd NA, Jewell DP. Changing pattern of gastric cancer in Oxfordshire. Gut 1992;33:1312-7.

12 -MacDonald WC MacDonald JB. Adenocarcinoma of the oesophagus and/or gastric cardia. Cancer 1987;60:1094-8.

13 -Craanen WE, Dekker W, Blok P, Ferwerda J, Tytgat GN. Time trends in gastric carcinoma: changing patterns of type and location. Am J Gastroenterol 1992;87:572-9.

14 -Popiela T, Kulig J, Kolodziejczyk 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.

15 -Lee JY, Kim HY, Kim KH, Jang HJ, Kim JB, Lee JH, et al. No changing trends in incidence of gastric cardia cancer in Korea. J Korean Med Sci 2003;18:53-7.

16 -Yang PC, Davis S. Epidemiological characteristics of carcinoma of the gastric cardia and distal stomach in the United States, 1973-1982. Int J Epidemiol 1988;17:293-7.

17 -Allum WH, Powell DJ, McConkey CC, Fielding JW. Gastric cancer: a 25-year review. Br J Surg 1989;76:535-40.

18 -Powell J, McConkey CC. Increasing incidence of adenocarcinoma of the gastric cardia and adjacent sites. Br J Cancer 1990;62:440-3.

19 -Blot WJ, Devesa SS, Kneller RW, Fraumeni JF Jr. Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA 1991;265:1287-9.

20 -Moller H. Incidence of cancer of oesophagus, cardia and stomach in Denmark. Eur J Cancer Prev 1992;1:159-64.

21 -Macfarlane GC, Plesko I, Kramarova E, Obsitnikova A, Boyle P. Epidemiological features of gastric and oesophageal cancers in Slovakia. Br J Cancer 1994;70:177-9.

22 -Harrison SL, Goldacre MJ, Seagroatt V. Trends in registered incidence of oesophageal and stomach cancer in the Oxford region, 1974-88. Eur J Cancer Prev 1992;1:271-4.

23 -Zheng T, Mayne ST, Holford TR, Boyle P, Liu W, Chen Y, et al. The time trend and age-period-cohort effects on the incidence of adenocarcinoma of the stomach in Connecticut from 1955-1989. Cancer 1993;72:330-40.

24 -Bouvier AM, Esteve J, Mitry E, Clinard F, Bonithon-Kopp C, Faivre J. Trends in gastric cancer incidence in a well-defined French population by time period and birth cohort. Eur J Cancer Prev 2002;11:221-7.

25 -Liu Y, Kaneko S, Sobue T. Trends in reported incidences of gastric cancer by tumour location, from 1975 to 1989 in Japan. Int J Epidemiol 2004;33:808-15.

26 -Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J, editors. Cancer Incidence in Five Continents. Vol. VII. IARC Sci Publ No. 143. Lyon: IARC; 1997.

27 -Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DB, editors. Cancer Incidence in Five Continents, Vol. VIII. IARC Sci Publ No. 155. Lyon: IARC; 2002.

28 -Armstrong RW, Borman B. Trends in incidence rates of adenocarcinoma of the oesophagus and gastric cardia in New Zealand, 1978-1992. Int J Epidemiol 1996;25:941-7.

29 -Hansen S, Wiig JN, Giercksky KE, Tretli S. Esophageal and gastric carcinoma in Norway 1958-1992: incidence time trend variability according to morphological subtypes and organ subsites. Int J Cancer 1997;71:340-4.

30 -Levi F, Randimbison L, La Vecchia C. Esophageal and gastric carcinoma in Vaud, Switzerland, 1976-1994. Int J Cancer 1998;160-1.

31 -Laheij RJ, Straatman H, Verbeek AL, Jansen JB. Mortality trend from cancer of the gastric cardia in The Netherlands, 1969-1994. Int J Epidemiol 1999;28:391-5.

32 -Ekstrom AM, Signorello LB, Hansson LE, Bergstrom R, Lindgren A, Nyren O. Evaluating gastric cancer misclassification: a potential explanation for the rise in cardia cancer incidence. J Natl Cancer Inst 1999;91:786-90.

33 -von Rahden BH, Feith M, Stein HJ. Carcinoma of the cardia: classification as esophageal or gastric cancer? Int J Colorectal Dis 2005;20:89-93.

34 -Corley DA, Kubo A. Influence of site classification on cancer incidence rates: an analysis of gastric cardia carcinomas. J Natl Cancer Inst 2004;96:1383-7.

35 -Corley DA, Buffler PA. Oesophageal and gastric cardia adenocarcinomas: analysis of regional variation using the Cancer Incidence in Five Continents database. Int J Epidemiol 2001;30:1415-25.

36 -Kubo A, Corley DA. Marked multi-ethnic variation of esophageal and gastric cardia carcinomas within the United States. Am J Gastroenterol 2004;99:582-8.

37 -Kubo A, Corley DA. Marked regional variation in adenocarcinomas of the esophagus and the gastric cardia in the United States. Cancer 2002;95:2096-102.

38 -Lauren P. The two histologial 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.

39 -Stemmermann GN, Brown C. A survival study of intestinal and diffuse types of gastric carcinoma. Cancer 1974;33: 1190-5.

40 -Ribeiro MM, Sarmento JA, Sobrinho-Simoes MA, Bastos J. Prognostic significance of Lauren and Ming classifications and other pathologic parameters in gastric carcinoma. Cancer 1981;47:780-4.

41 -Adachi Y, Yasuda K, Inomata M, Sato K, Shiraishi N, Kitano S. Pathology and prognosis of gastric carcinoma: wellversus poorly differentiated type. Cancer 2000; 89:1418-24.

42 -Huang J, Sridhar S, Chen Y, Hunt RH. Meta-analysis of the relationship between Helicobacter pylori seropositivity and gastric cancer. Gastroenterology 1998;114:1169-79.

43 -Munoz N, Correa P, Cuello C, Duque E. Histologic types of gastric carcinoma in high- and low-risk areas. Int J Cancer 1968;3:809-18.

44 -Ekstrom AM, Hansson LE, Signorello LB, Lindgren A, Bergstrom R, Nyren O. Decreasing incidence of both major histologic subtypes of gastric adenocarcinoma-a population-based study in Sweden. Br J Cancer 2000;83:391-6.

45 -Lauren 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.

46 -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.

47 -Kaneko S, Yoshimura T. Time trend analysis of gastric cancer incidence in Japan by histological types, 19751989. Br J Cancer 2001;84:400-5.

48 -Maartmann-Moe H, Hartveit F. On the reputed decline in gastric carcinoma: necropsy study from western Norway. Br Med J (Clin Res Ed) 1985;290:103-5.

49 -Parkin DM, Muir CS, Whelan SL, Gao YT, Ferlay J, Powell J, editors. Cancer Incidence in Five Continents. Vol. VI. IARC Sci Publ No. 120. Lyon: IARC; 1992.

50 -Correa P, Sasano N, Stemmermann GN, Haenszel W. Pathology of gastric carcinoma in Japanese populations: comparisons between Miyagi prefecture, Japan, and Hawaii. J Natl Cancer Inst 1973;51:1449-59.

51 -Tahara E. Genetic pathways of two types of gastric cancer. IARC Sci Publ 2004;(157):327-49.



Prof. Nuno Lunet

Serviço de Higiene e Epidemiologia

Faculdade de Medicina da Universidade do Porto

Alameda Prof. Hernâni Monteiro 4200-319 Porto


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License