Diet and Gastric Cancer

Abstract

Worldwide, gastric cancer is the fourth most common cancer and the second leading cause of cancer death (Parkin et al. 2005). In 2002, approximately 933,937 men and women were diagnosed with gastric cancer, and 700,349 died from gastric cancer worldwide (Parkin et al. 2005). In the United States, gastric cancer is relatively uncommon, and ranked fourteenth among both incident cancers and cancer deaths with approximately 22,280 new cases and 11,430 deaths in 2006 (Jemal et al. 2006). The death rate from gastric cancer has steadily decreased over the last several decades in the United States (Jemal et al. 2006) and worldwide (Parkin et al. 2005), suggesting that environmental factors such as diet have a critical role in the etiology of this malignancy. Growing evidence indicates that gastric cardia and noncardia cancer differ in etiology (Devesa et al. 1998). For example, Helicobacter pylori infection is an established strong risk factor for gastric noncardia cancer, but it is not associated with the risk for gastric cardia cancer (Engel et al. 2003; Helicobacter and Cancer Collaborative Group 2001). In addition, the incidence rate of gastric cardia cancer has increased in the United States (Corley and Kubo 2004; Devesa et al. 1998; Devesa and Fraumeni 1999) and European countries (Botterweck et al. 2000a), whereas the incidence rate of gastric noncardia cancer has steadily decreased (Corley and Kubo 2004). It has been suggested that the increasing rate of obesity is contributing to the increase in gastric cardia cancer (Engel et al. 2003; Kubo and Corley, 2006). Other established risk factors for gastric cancer include age and tobacco smoking (Engel et al. 2003; Freedman et al. 2007; Kelley and Duggan, 2003; Sjodahl et al. 2007).