Survival in gastric cancer: A population-based cancer registry among residents in Shanghai, China.

Abstract

e12014 Background: Gastric cancer (GC) is one of the leading cancers both in terms of incidence and mortality in China. No large population-based epidemiological study of clinical characteristics and survival of GC has been reported in China. Methods: The data for this study were derived from the Shanghai Cancer Registry, compiled by the Shanghai Center for Disease Control and Prevention (Shanghai CDC). Consecutive, non-selected patients diagnosed with GC between January 1, 2002 and December 31, 2003 were included in the analyses. All newly diagnosed GC patients in any hospital in Shanghai were encouraged to participate in this registry and fill in a registry form. All registered cases were followed by the surveillance network of Shanghai CDC. Reports of deaths from hospitals, living status from the community, or loss to follow-up were updated through December 31, 2009. Cancer was staged using the International Union Against Cancer (UICC) version 6. Frequency and overall survival were examined. Results: 10 909 gastric cancer cases (male 64.5%, female 35.5%) were included in the study with a median age of 69 years. Stage was unknown for 6366 cases (58.4%); 5.5%, 9.9%, 12.4% and 13.8% were stage I to stage IV, respectively. For anatomic location of the tumor, 12.6% of cases were located in cardia, 43.5% were in non-cardia, while a large proportion of cases (44.0%) were unknown. There was no substantial difference in 5-year survival between men and women (25.3% vs. 27.5%, P= 0.18). However, 5-year survival rates varied significantly by tumor stage (67.5% in stage I, 48.5% in stage II, 26.5% in stage III, 7.5% in stage IV, and 22.7% in unknown staging cases, P<0.001). This was also true of anatomic location (18.8% at cardia, 33.6% at non-cardia, 20.7% at unknown status cases, P<0.001). Conclusions: Results from this large population-based registry indicate that treatment of GC in Shanghai may be challenging due to considerable late diagnosis and comparatively poor prognosis. Early detection and diagnosis should be encouraged.