Journal of Clinical Epidemiology
Volume 56, Issue 1 , Pages 1-9, January 2003

Gastric cancer epidemiology and risk factors

  • Jon R. Kelley

      Affiliations

    • Department of Veterans' Affairs, Commonwealth of Australia, G.P.O. Box 651, Brisbane Queensland 4001, Australia
    • ,
  • John M. Duggan

      Affiliations

    • Corresponding Author InformationCorresponding author. Princeton Medical Centre, 60 Lindsay Street, Hamilton, NSW, 2303, Australia. Tel.: 61 2 49 61 2090; fax: 61 2 49 62 3443.
    • Repatriation Medical Authority, Commonwealth of Australia, G.P.O. Box 1014, Brisbane Queensland, Australia
    • Discipline of Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health Science, University of Newcastle, Pacific Street, Newcastle, NSW 2300, Australia

Received 30 May 2001; received in revised form 26 June 2002; accepted 19 July 2002.

Abstract 

We performed a detailed analysis of the epidemiology of gastric carcinoma, based upon a review of the literature in English. The analysis reveals many puzzling features. There has been a steady fall in the incidence of gastric carcinoma in most societies studied, but a more recent steady rise in the incidence of adenocarcinoma of the cardia and lower esophagus, largely confined to White males. Although the evidence for a major role for Helicobacter pylori (H. pylori) in the etiology of gastric corpus cancer is compelling; in Western society, it probably accounts for fewer than half the cases. The relative roles of dietary constituents such as salt and nitrites and the phenotyping of H. pylori in causation and the beneficial effects of a high fruit and vegetable diet and an affluent lifestyle, for all of which there is some evidence, are yet to be quantified.

Keywords:  Gastric cancer, Epidemiology, H. pylori, Heredity, Diet

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PII: S0895-4356(02)00534-6

Journal of Clinical Epidemiology
Volume 56, Issue 1 , Pages 1-9, January 2003

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