Abstract
Stomach cancer is the second most common cause of death from all malignant tumors in the world (third in men, fifth in women), with a strong decreasing trend in most developed countries. The aim of this descriptive epidemiological study was to analyze mortality of stomach cancer in Serbia, excluding the Province of Kosovo, in the 1991-2009 period. In data analysis, we used mortality rates which were standardized directly using those of the world population as a standard. In order to analyze the mortality trend from stomach cancer, linear trend and regression analysis were used. Confidence intervals (CIs) for the average age-adjusted and age-specific mortality rates were assessed with 95% level of probability. Mortality data were derived from the data file of the Statistical Office of the Republic of Serbia. During the 1991-2009 period, a significant downward trend in mortality of stomach cancer was recorded in Serbia (y=9.78 - 0.13x, p=0.000; average annual percent change was - 6.3 (95%CI, -7.8 to - 4.8). During the same period, a significant decrease in mortality trend was found both in male (y=14.13 - 0.20x; p=0.000; % change was -7.7 (95%CI, -10.9 to -4.5) and female populations (y=6.27 - 0.08x; p=0.000; % change was - 4.4 (95%CI, -5.3 to -3.6). Decreasing trends in mortality from stomach cancer in Serbia are similar to those in most developed countries.
Highlights
Malignant stomach tumors are the second leading cause of death among malignant tumors, with more than 730,000 deaths, accounting for 10% of total deaths worldwide in 2008 (Jemal et al, 2011)
During the 1991-2009 period, a significant downward trend in mortality of stomach cancer was recorded in Serbia (y=9.78 - 0.13x, p=0.000; average annual percent change was - 6.3 (95%Confidence intervals (CIs), -7.8 to - 4.8)
Over the 19-year observation period, in the Republic of Serbia, excluding the Province of Kosovo, a significant decrease in total mortality was observed (y=799.317.78x; p=0.000; % average annual percent change=- 0.10 (95%CI=-0.13 to -0.07)), with a significant increase in deaths from all malignant tumours (y=119.69+1.18x; p=0.000; %change=+0.82 (95%CI=0.74-0.90) (Figure 1)
Summary
Malignant stomach tumors are the second leading cause of death among malignant tumors, with more than 730,000 deaths, accounting for 10% of total deaths worldwide in 2008 (Jemal et al, 2011). The highest stomach cancer mortality rates in 2008 were recorded in Asia (Mongolia - 26.5 per 100,000 inhabitants, China - 22,3 per 100,000 inhabitants, Bhutan - 22.1 per 100,000 inhabitants) (IARC, 2008). The lowest mortality rates were recorded in certain South African countries (Botswana - 0.3 per 100,000 inhabitants and Namibia - 1.1 per 100,000 inhabitants), and United States of America - 2.0 per 100,000 inhabitants. Over 75% of stomach cancer cases (556,471 cases) occur in developing countries (353,685 men vs 202,786 women) (IARC, 2008; Jemal et al, 2011). 72% of deaths were recorded in Asia, almost 66.5% of which occurred in China. Stomach cancer rates are about twice as high in males as in females (Parkin, 2004; Ferlay et al, 2010; Jemal et al, 2011). The mortality of stomach cancer has decreased considerably in most developed countries over the past several decades (Levi et al, 2003). But with later onset, were observed in some Asian countries, including Japan and China (Lee et al, 2006)
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