Abstract
BackgroundThe gastric cancer incidence rate differs widely across geographical areas. In Italy, in the province of Cremona the incidence is high, compared to the national situation. For this reason a specialized population-based registry was set up.MethodsThe collection encompasses all gastric cancers diagnosed in the three districts of the province since January 1, 2010. The main data sources were the pathological and Hospital Discharge Records and patient clinical charts. Only diagnoses of primary gastric cancer were considered. For each case the following variables were registered: personal data, medical history and symptoms at diagnosis; imaging assessments performed, details on surgery and other treatments received; genetic background and biomolecular characteristics; social and environmental factors.ResultsAs of November 2017, 1087 cases were collected; of which 876, diagnosed up to December 2015, were analyzed. Male/female ratio was 1.4. The European Age-standardized Incidence Rate was 41.4 for males and 28.3 for females as compared to a national average of 33.3 and 17.0 respectively. Median age at diagnosis was 73 for male and 78 for female. Helicobacter Pylori infection was present in fewer than 20% of cases. HER-2 gene was amplified in about 25% of cases. Primary tumour location was the gastro-esophageal junction or cardia in 17.5% in males and 8.3% in females. The majority of cases (58.3%) were diagnosed at an advanced stage and overall only 41.2% underwent surgery. Median overall survival was 14.8 months for men and 18.5 for women. Age standardized 5-year relative survival was 31.4% for men and 40.5% for females. Neoadjuvant treatment was performed in fewer than 10% of patients who underwent surgery, and the rate of postoperative therapy adherence was low.DiscussionThis study shows a high gastric cancer incidence in the province of Cremona, with a geographical spread across different districts. Moreover, a high percentage of gastric cancers were detected at an advanced stage of disease and a low rate of 5-year relative survival was registered. Based on these findings, effective preventive interventional health strategies and screening procedures need to be implemented to reduce the impact of this pathology in this geographical area.
Highlights
The gastric cancer incidence rate differs widely across geographical areas
Histological confirmation was available for 92.7% of cases, while the remainder were gastric cancer (GC) cases diagnosed clinically and by radiological assessment as computed tomography scan, CT scan, or abdominal ultrasound without tissue biopsy
Symptoms leading to GC diagnosis Data was investigated in 538 GC pts
Summary
The gastric cancer incidence rate differs widely across geographical areas. In Italy, in the province of Cremona the incidence is high, compared to the national situation. For this reason a specialized population-based registry was set up. Epidemiology of GC is characterized by a wide variation in incidence and mortality rates across different geographical areas, as reported in GLOBOCAN [1]. In the northern part, the province of Cremona presents high GC mortality rates. This has been noticed since 1996 [8] but the province lacks accurate data to monitor the situation. Owing to the very poor prognosis of stomach cancer, the results of epidemiological and experimental studies are fundamental to develop primary prevention strategies [9]
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