Abstract
BackgroundAlthough impacts upon gastric cancer incidence of race, age, sex, and Lauren type have been individually explored, neither their importance when evaluated together nor the presence or absence of interactions among them have not been fully described.MethodsThis study, derived from SEER (Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute) data, analyzed the incidences of gastric cancer between the years 1992–2001. There were 7882 patients who had developed gastric cancer. The total denominator population was 145,155, 669 persons (68,395,787 for 1992–1996, 78,759,882 for 1997–2001). Patients with multiple tumors were evaluated as per the default of the SEER*Stat program. 160 age-, five year period (1992–1996 vs 1997–2001)-, sex-, race (Asian vs non-Asian)-, Lauren type- specific incidences were derived to form the stratified sample evaluated by linear regression. (160 groups = 2 five year periods × 2 race groups × 2 sexes × 2 Lauren types × 10 age groups.) Linear regression was used to analyze the importance of each of these explanatory variables and to see if there were interactions among the explanatory variables.ResultsRace, sex, age group, and Lauren type were found to be important explanatory variables, as were interactions between Lauren type and each of the other important explanatory variables. In the final model, the contribution of each explanatory variable was highly statistically significant (t > 5, d.f. 151, P < 0.00001). The regression equation for Lauren type 1 had different coefficients for the explanatory variables Race, Sex, and Age, than did the regression equation for Lauren type 2.ConclusionThe change of the incidence of stomach cancer with respect to age for Lauren type 1 stomach cancer differs from that for Lauren type 2 stomach cancers. The relationships between age and Lauren type do not differ across gender or race. The results support the notion that Lauren type 1 and Lauren type 2 gastric cancers have different etiologies and different patterns of progression from pre-cancer to cancer. The results should be validated by evaluation of other databases.
Highlights
Impacts upon gastric cancer incidence of race, age, sex, and Lauren type have been individually explored, neither their importance when evaluated together nor the presence or absence of interactions among them have not been fully described
An array of histologic classifications is in use, that proposed by Lauren [2], retains its durability because its two types have been the most widely compared and because pathologists can reproducibly distinguish Lauren type 1 from Lauren type 2 cancers [3]
The Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute is an authoritative source of information on cancer incidence and survival in the United States that currently collects and publishes cancer incidence and survival data from 14 population-based cancer registries and three supplemental registries covering approximately 26 percent of the US population; the SEER website provides extensive information about it [42]
Summary
Impacts upon gastric cancer incidence of race, age, sex, and Lauren type have been individually explored, neither their importance when evaluated together nor the presence or absence of interactions among them have not been fully described. Year of diagnosis [4,5,6,7,8,9,10,11,12,13,14,15], gender [5,12,1625], race [22,26,27,28,29,30,31,32,33], age [10,13,14,16,18,19,21,24,26,3538], and Lauren type [5,11,18,19,26,27,35,39,40,41], have all been found by recent epidemiologic studies to be important explanatory variables for stomach cancer incidence; various interactions among these variables have been demonstrated [5,10,11,12,13,14,16,19,22,24,35]. The study used SEER to evaluate the contributions of age, sex, race (Asian vs non-Asian), year of diagnosis (1992– 1996 vs 1997–2001), and Lauren type to gastric cancer incidence. Incidence was considered in terms of the natural logarithms of the rates of development, over a five year period, of stomach cancer
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