High Incidence Of Stomach Cancer Research Articles

Clinical Outcomes of Resectional Roux-en-Y Gastric Bypass, Compared to Sleeve Gastrectomy for Severe Obesity.

Resectional Roux-en-Y gastric bypass (RRYGB) is considered an alternative bariatric surgery in countries with a high incidence of stomach cancer because there is no excluded stomach after RRYGB. This study aimed to evaluate the efficacy and safety of RRYGB. This study included patients who underwent RRYGB and sleeve gastrectomy (SG) between 2011 and 2021. Surgical complications and metabolic and nutritional profiles were compared between the patients preoperatively and at 1, 6, and 12months after surgery. Twenty and seventy-six patients underwent RRYGB and SG, respectively; 7 in the SG group were lost to follow-up within 1year. Surgical complications and baseline characteristics were comparable between two groups, except for diabetes (90.0% vs. 44.7%, p < 0.001). The decrease of HbA1c levels and incidence of reflux esophagitis were lower in the RRYGB group compared to that of SG at 1-year postoperative (-3.0% vs. -1.8%, p = 0.014; 0% vs. 26.7%, p = 0.027). The percentage of total weight loss at 1- year postoperative and incidence of dumping syndrome were comparable between the two groups. The RRYGB group had significantly lower total cholesterol level (161.9mg/dl vs. 196.4mg/dl, p < 0.001), but higher incidence of vitamin B12 deficiency (30.0% vs. 3.6%, p = 0.003) at 1year postoperative compared to those of the SG group. The RRYGB group had better postoperative outcomes for diabetes and dyslipidemia without increasing surgical complications compared to that of the SG group. Thus, RRYGB can be considered a safe and effective alternative in areas where gastric cancer is prevalent.

A Study on the Relationship between Blood Group and Type of Cancer

The presence and lack of blood antigens in some blood groups induce blood membrane changes, morphologically and functionally, and it is related to some kind of disease such as cancer. Structure-dependent functions of blood types can relate the blood groups to health and diseases. The study aimed to determine the association of "ABO" and "Rhesus" blood groups with the frequency of cancer. A total of 576 cancer patients participated in this study, and they were diagnosed with different types of cancer. The results showed that blood types A and O have a high rate of occurrence of breast cancer and lung cancer, the positive Rhesus blood type has a high incidence of breast cancer. Meanwhile, the Rhesus negative blood type has a high incidence of stomach cancer. In conclusion, this study supports previous studies about the relationship between the blood group type and the probability of cancers occurring.

Burden of gastric and digestive cancers in the French Caribbean: perspectives from population-based cancer registries of Martinique, Guadeloupe and French Guiana (2007–2014)

ObjectivesData from population-based cancer registries contribute to improving our knowledge of digestive cancer trends worldwide. In this study, we present cancer incidence and mortality in Guadeloupe, French Guiana and Martinique...

Takashi Sugimura: In Memoriam (1926–2020)–A Personal Perspective

![][1] Takashi Sugimura was a pioneer in cancer research and a figure recognized internationally for his seminal contributions to the understanding of mutagenicity and chemical carcinogenesis. Rather than focusing on the many accolades, honors, and influential positions that he held,

A 25-year trend in gastrointestinal cancers in northern Iran (1991-2016).

Background:Identifying the incidence of cancer helps in planning and prioritizing resources for its screening, prevention, treatment and diagnosis. This study aimed at investigating a 25-year trend in gastrointestinal cancer in northern Iran during 1991-2016.Methods:This research was a trend analysis. The study population was one thousand five hundred and thirty-five cancer patients referring to Shahid Rajai Hospital in Babolsar, northern Iran, as the only center for radiotherapy in the North of Iran, during 1991-2016. SPSS version 22 was used for entering data and t-test, ᵡ2 and ANOVA were used for analyzing data in the significant level of ≤0.05.Results:The highest incidence of stomach cancer was 111 (35%) in 2011 and the lowest incidence was 44 (16.3%) in 1996, The highest frequency of esophageal cancer was reported 137(56.1%) cases in 1991 and the lowest frequency was 78 (26.3%) cases in 2016, while the highest incidence of colorectal cancer was 109 (36.7%) cases in 2016 and its lowest frequency was 32 (16.3%) in 1996. There was also a significant difference in the frequency of gastrointestinal cancers in different studied years (p <0.001).Conclusion:The trends in the incidence of stomach and colorectal cancers in northern Iran were increasing while esophageal cancer was decreasing.

Ethnic differences in the incidence of cancer in Norway.

Traditionally there have been differences in cancer incidence across geographic regions. When immigrants have moved from low-income to high-income countries, their incidence have changed as they have adapted to the lifestyle in the new host country. Given worldwide changes in lifestyle factors over time, we decided to examine cancer incidence in immigrant groups in Norway, a country with a recent immigration history, complete cancer registration and universal public health care. We linked immigration history for the complete population to information on cancer diagnosis from the Cancer Registry of Norway for the period 1990-2012. Age-standardized (world) overall and site-specific cancer incidence were estimated for different immigrant groups and compared to incidence among individuals born in Norway. Among 850,008 immigrants, 9,158 men and 10,334 women developed cancer, and among 5,508,429 Norwegian-born, 263,316 men and 235,020 women developed cancer. While incidence of breast and colorectal cancer were highest among individuals born in Norway and other high-income countries, other cancer types were higher in immigrants from low-income countries. Lung cancer incidence was highest in Eastern European men, and men and women from Eastern Europe had high incidence of stomach cancer. Incidence of liver cancer was substantially higher in immigrants from low-income countries than in individuals born in Norway and other high-income countries. Our results mirror known cancer challenges across the world. Although cancer incidence overall is lower in immigrants from low-income countries, certain cancers, such as lung, liver and stomach cancer, represent major challenges in specific immigrant groups.

Effect of nursing care given at home on the quality of life of patients with stomach cancer and their family caregivers' nursing care.

In Turkey, the high incidences of stomach and oesophageal cancers in East and high incidence of stomach cancer in Northeast regions are remarkable. This study was conducted to identify homecare needs of patients with stomach cancer and their caregivers and the effect of family supportive nursing care on the quality of life of patients and families. The patient and his/her caregiver were assessed with respect to their daily life activities and NANDA was used for the identified nursing diagnoses, NIC for the appropriate interventions and NOC for assessment of the results. This study was conducted in a pre-test, post-test, controlled trial model to identify. The sample of the investigation consisted of 72 patients and 72 caregivers. As a data-collecting instrument, the Quality of Life Scale and Caregiver Quality of Life Index-Cancer were used. The overall quality of life, global health status and emotional and cognitive functions of the patients in the experimental group improved after the interventions. The overall quality of life and global health status was found to be poorer in the control group patients at post-test as compared to pre-test and their physical, role and social functions deteriorated. The caregivers' quality of life in the control group was affected more negatively with respect to the "Disruption in Daily Life" subscale as compared to pre-test values.

RISK AND PROTECTIVE FACTORS FOR GASTRIC METAPLASIA AND CANCER: A HOSPITAL-BASED CASE-CONTROL STUDY IN ECUADOR.

worldwide, stomach cancer is the fifth most frequent cancer, with 952 000 new cases diagnosed in 2012. Ecuador currently holds the 15th place of countries with the highest incidence of stomach cancer for both sexes. the objective of this study was to evaluate risk and protective factors for gastric cancer/metaplasia. a hospital-based case-control study was conducted in Quito, Ecuador. Cases were defined as patients with histological confirmation of gastric cancer (N = 60) or incomplete gastric metaplasia (N = 53). Controls were defined as patients free of gastric cancer or premalignant lesions (N = 144). All participants were personally interviewed using a structured questionnaire to collect data about dietary habits, lifestyle and medical history. risk factors significantly associated to the presence of gastric cancer/metaplasia were the consumption of reheated foods at least 3 times per week (AOR: 4.57; CI: 2.2 - 9.5) and adding salt to more than 50% of foods (AOR: 1.32; CI: 1.04 - 1.67). Protective factors for gastric cancer/metaplasia were the use of non-steroidal anti-inflammatory drugs (AOR: 0.39; CI 0.19 - 0.83), age less than 58 years old (AOR: 0.38; CI: 0.18 - 0.79) and have received treatment for H. Pylori infection (AOR: 0.33; CI: 0.16 - 0.71). this study reports for the first time, the risk and protective factors associated with gastric cancer and metaplasia in Ecuador.

Risk Factors and Epidemiology of Gastric Cancer in Pakistan.

Gastric cancer is the 2nd most common cause of death among all cancers and is the 4th most common cancer in the world. The number of deaths due to gastric cancer is about 800,000 annually. Gastric cancer is more common in men as compared to women and is 3rd most common cancer after colorectal and breast cancers in women. A progressive rise in the incidence rate has been observed in females over the last 5 years. The highest incidence of stomach cancer is in China, South America and Eastern Europe. The incidence of gastric cancer has 20 fold variation worldwide. Global variation is linked by two factors which play important role in developing gastric cancer. One is infection with Helicobacter pylori and the 2nd is diet. South Asia is a region with low risk, despite a high prevalence of H.pylori. Gastric carcinoma is common in southern region of India. Gastric cancer is more readily treated if diagnosed early. This study aims to provide awareness about gastric cancer as well as an updated knowledge about risk factors and epidemiology of gastric cancer in Pakistan.

Abstract 4807: Soy and salty food intake and risk of stomach cancer in Seoul Male Cohort.

Abstract Stomach cancer is the most common cancer among men in Korea. High prevalence of H. pylori infection and salty food intake has been suspected to be the main contributors of the high incidence of stomach cancer in Korea. Many studies reported an inverse association between soy food and risk of stomach cancer, but some studies showed that fermented soy food increased the risk of stomach cancer probably due to the high concentration of salt in it. We aimed to evaluate the association between fermented and non-fermented soy, and other salty food and the risk of stomach cancer in a prospective cohort study in Korea. Seoul Male Cohort was established in 1993. Members were recruited from the male beneficiaries of the Korean Health Insurance Company, who were aged 40-59 and living in Seoul. A lifestyle questionnaire survey was conducted through mailing. Dietary intake was measured using a quantitative food frequency questionnaire with 88 food items. Cancer occurrence was identified through data linkage to the Korean Central Cancer Registry and Korean Death Records. A total of 14,512 members were followed up until December 31, 2008, and 362 stomach cancer cases were identified. Total calorie adjusted multivariable odds ratio (aOR) and 95% confidence interval (95%CI) were calculated using logistic regression. Soybean paste stew, a very popular fermented soy food in Korea, was positively associated with the risk of stomach cancer. Men who ate soybean paste stew 2∼3 cups per week had 1.45 times higher risk of stomach cancer than men who ate less than one cup per week (95% CI = 1.11-1.92). Non-fermented soy foods, including soybean, tofu, and soy drink, were not associated with the risk of stomach cancer. The aOR of stomach cancer for the highest intake of soybean compared to the lowest intake was 1.02 (95%CI = 0.77-1.36), for the highest intake of tofu was 1.05 (95%CI = 0.75-1.46), for the highest intake of soy drink was 1.11 (95%CI = 0.84-1.47). Other salty foods, including Kimchi stew (highest vs. lowest, aOR=1.47, 95%CI=1.05-2.06), and salt-fermented radish (highest vs. lowest, aOR=1.45, 95%CI=1.11-1.90) were positively associated with the risk of Stomach cancer. However, Kimchi itself, the most popular salt-fermented vegetable in Korea, was not associated with the risk of stomach cancer (highest vs. lowest, aOR=1.06, 95%CI=0.77-1.46). In conclusion, we found no evidence of inverse association between non-fermented soy food and risk of stomach cancer. When soy is fermented, its high concentration of salt may increase the risk of stomach cancer. Most of the other salty foods may increase the risk of stomach cancer. Citation Format: Myung-Hee Shin, Seon-Mi Hwang, Jong-Myon Bae, Moo-Song Lee, Dong-Hyun Kim, Zhong-Min Li, Yoon-Ok Ahn. Soy and salty food intake and risk of stomach cancer in Seoul Male Cohort. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4807. doi:10.1158/1538-7445.AM2013-4807

Genetic Polymorphism of Glutathione S-transferases M1 and T1, Tobacco Habits and Risk of Stomach Cancer in Mizoram, India

The incidence of stomach cancer in Mizoram is highest in India. We have conducted a population based matched case-control study to identify environmental and genetic risk factors in this geographical area. A total of 102 histologically confirmed stomach cancer cases and 204 matched healthy population controls were recruited. GSTM1 and GSTT1 genotypes were determined by PCR and H. pylori infections were determined by ELISA. Tobacco-smoking was found to be an important risk factor for high incidence of stomach cancer in Mizoram. Meiziol (local cigarette) smoking was a more important risk factor than other tobacco related habits. Cigarette, tuibur (tobacco smoke infused water) and betel nut consumption synergistically increased the risk of stomach cancer. Polymorphisms of GSTM1 and GSTT1 genes were not found to be directly associated with stomach cancer in Mizoram. However, they appeared to be effect modifiers. Persons habituated with tobacco smoking and/or tuibur habit had increased risk of stomach cancer if they carried the GSTM1 null genotype and GSTT1 non-null genotype. Tobacco smoking, especially meiziol is the important risk factor for stomach cancer in Mizoram. GSTM1 and GSTT1 genes modify the effect of tobacco habits. This study is a first step in understanding the epidemiology of stomach cancer in Mizoram, India.

The Effect of Preparatory Education Program on Discomfort and Retching of Examinees during Upper Gastrointestinal Endoscopy

BackgroundAlthough upper gastrointestinal (UGI) endoscopy is highly sensitive for the detection of esophago-gastroduodenal lesions, pain and discomfort during the procedure cause examinees to experience stress and anxiety. Moreover, there have been only a few studies on relief of pain and discomfort during UGI endoscopy through preparatory interventions. Therefore, the aim of this study was to investigate the relationship between a preparatory education program and the discomfort and retching experienced by examinees during endoscopy.MethodsA total of 306 examinees who visited a health promotion center and underwent non-sedated endoscopy from May 13 to July 3, 2009 were included in this study. After they were assigned to experimental (n = 154) and control groups (n = 152), their discomfort and retching were measured with a visual analogue scale. The preparatory education program consisted of cognitive intervention, behavioral intervention and information.ResultsThe preparatory education program relieved discomfort during endoscopy in male subjects, in subjects aged 60 and over, or in subjects with previous endoscopic experience with statistical significance (P < 0.05). It also relieved retching during endoscopy in subjects aged 60 and over with statistical significance (P = 0.023). Multiple logistic regression analysis showed that the preparatory education program significantly relieved the discomfort of examinees during endoscopy (P = 0.028).ConclusionWe found that the preparatory education program used in this study could significantly relieve the discomfort caused by endoscopy, particularly in subjects aged 60 and over, or in male subjects with a high incidence of stomach cancer in Korea.

Evolution in an oncogenic bacterial species with extreme genome plasticity: Helicobacter pyloriEast Asian genomes

BackgroundThe genome of Helicobacter pylori, an oncogenic bacterium in the human stomach, rapidly evolves and shows wide geographical divergence. The high incidence of stomach cancer in East Asia might be related to bacterial genotype. We used newly developed comparative methods to follow the evolution of East Asian H. pylori genomes using 20 complete genome sequences from Japanese, Korean, Amerind, European, and West African strains.ResultsA phylogenetic tree of concatenated well-defined core genes supported divergence of the East Asian lineage (hspEAsia; Japanese and Korean) from the European lineage ancestor, and then from the Amerind lineage ancestor. Phylogenetic profiling revealed a large difference in the repertoire of outer membrane proteins (including oipA, hopMN, babABC, sabAB and vacA-2) through gene loss, gain, and mutation. All known functions associated with molybdenum, a rare element essential to nearly all organisms that catalyzes two-electron-transfer oxidation-reduction reactions, appeared to be inactivated. Two pathways linking acetyl~CoA and acetate appeared intact in some Japanese strains. Phylogenetic analysis revealed greater divergence between the East Asian (hspEAsia) and the European (hpEurope) genomes in proteins in host interaction, specifically virulence factors (tipα), outer membrane proteins, and lipopolysaccharide synthesis (human Lewis antigen mimicry) enzymes. Divergence was also seen in proteins in electron transfer and translation fidelity (miaA, tilS), a DNA recombinase/exonuclease that recognizes genome identity (addA), and DNA/RNA hybrid nucleases (rnhAB). Positively selected amino acid changes between hspEAsia and hpEurope were mapped to products of cagA, vacA, homC (outer membrane protein), sotB (sugar transport), and a translation fidelity factor (miaA). Large divergence was seen in genes related to antibiotics: frxA (metronidazole resistance), def (peptide deformylase, drug target), and ftsA (actin-like, drug target).ConclusionsThese results demonstrate dramatic genome evolution within a species, especially in likely host interaction genes. The East Asian strains appear to differ greatly from the European strains in electron transfer and redox reactions. These findings also suggest a model of adaptive evolution through proteome diversification and selection through modulation of translational fidelity. The results define H. pylori East Asian lineages and provide essential information for understanding their pathogenesis and designing drugs and therapies that target them.

Hereditary Nonpolyposis Colorectal Cancer (Lynch Syndrome) in Argentina: Report from a Referral Hospital Register

The first Argentine experience with epidemiologic, molecular, and genetic counseling data is reported. We analyzed 43 families fulfilling Amsterdam criteria identified from a prospective database with data from 779 relatives. Eleven families (25.6 percent) presented as Lynch I, 29 (67.4 percent) as Lynch II, and 3 (7 percent) as Muir-Torre syndrome. Among the 306 affected members, 197 cases of colorectal cancer were identified (mean age at diagnosis, 52.1 (range, 21-90) years). The most frequent extracolonic tumors were gastric adenocarcinoma in males and endometrium adenocarcinoma in females. A high incidence of breast cancer was observed (16 cases among 155 females, crude rate: 11,594.20/100,000). Twenty-seven patients (8.8 percent) developed more than one tumor. These patients were younger than those with only one tumor (45 vs. 51 years; P = 0.001). In 5 of 11 patients who underwent molecular sequencing, a pathologic mutation was found. A novel C deletion at 1910 nucleotide, codon 637, exon 12 of MSH2 gene was identified in a family with a strong aggregation of breast cancer with lack of MSH2 immunohistochemical staining. For 78.2 percent of counseled individuals, this session represented the first time they received information, and 73.9 percent stated that their physicians were unaware of their family background. Argentine families presented a high incidence of stomach cancer. The elevated incidence of breast cancer and its association with a novel hMSH2 mutation bring to consideration the inclusion of this malignancy as part of the syndrome. A lack of awareness by both physicians and persons at risk was observed.

Numerical aberrations of chromosome 8 detected by conventional cytogenetics and fluorescence in situ hybridization in individuals from northern Brazil with gastric adenocarcinoma

Gastric cancer is the third most frequent type of neoplasia and the second most important cause of cancer-related death in the world. In northern Brazil, the state of Pará shows a high incidence of this disease and the capital ranks among cities with the highest incidence of stomach cancer in the world. To evaluate chromosomal aberrations implicated in gastric carcinogenesis, we analyzed 16 samples of gastric adenocarcinoma by fluorescence in situ hybridization using a chromosome 8 α-satellite probe and by direct chromosomal analysis techniques. All lesions were classified as at advanced stages according to the recommendations of the Union Internationale Contre le Cancer (UICC). Trisomy 8 was the main finding of this study, observed in all cases. There was no significant difference between chromosome 8 ploidy and localization, stage, or histological type of adenocarcinoma in our sample. The high incidence of alterations we found in chromosome 8 may be a regional characteristic, related to the high incidence of this neoplasm in Pará state and a strong influence of external factors, such as eating habits. This aberration may comprise a cytogenetic subgroup of this neoplasm. Additional investigations are necessary to confirm the involvement of chromosome 8 and to identify genes in this chromosome related to gastric carcinogenesis.

Cancer incidence among marine engineers, a population-based study (Iceland).

Marine engineers are in their occupation exposed to different chemicals, organic solvents, exhaust gases, oils, and petroleum products, and were formerly exposed to asbestos. The aim was to study the cancer pattern, with particular attention to lung and bladder cancer, in an Icelandic cohort of marine engineers, indirectly controlling for their smoking habits. A cohort of 6603 male marine engineers was followed up from 1955 to 1998, a total of 167,715 person-years. The cohort was record linked by the engineers' personal identification numbers to population-based registers containing the vital and emigration status and cancer diagnosis. Standardized incidence ratios (SIRs) were calculated for all cancers and different cancer sites in relation to different lag time and year of graduation. Information on smoking habits was obtained by administering a questionnaire to a sample of the cohort (n = 1,501). In the total cohort 810 cancers were observed, whereas 794 were expected (SIR 1.0, 95% CI 1.0-1.1), and significantly increased risk of stomach cancer (SIR 1.3, 95% CI 1.0-1.5) and lung cancer (SIR 1.2, 95% CI 1.0-1.5) was found. Increased risk of all cancers (SIR 1.2, 95% CI 1.1-1.3), stomach cancer (SIR 1.5, 95% CI 1.1-1.9), lung cancer (SIR 1.4, 95% CI 1.2-1.8), pleural mesothelioma (SIR 4.8, 95% CI 1.3-12.3), and urinary bladder cancer (SIR 1.3, 95% CI 1.0-1.8) were observed when a 40-year lag time was applied. The engineers' smoking habits were similar to those in a sample of the general population. The predictive value for lung cancer was 1.03. The increased risk for mesothelioma is possibly attributable to the previous asbestos exposure. The excess of lung cancer could also be related to asbestos exposure. The high incidence of stomach cancer, lung cancer, and bladder cancer may be related to exposure to chemical risk factors, such as oils and petroleum products, as confounding due to smoking seems to be ruled out. In the light of the limited exposure information in the present study the importance of the different occupational exposures needs to be evaluated in further studies.

Determination of mineral and trace elements in total diet by inductively coupled plasma atomic emission spectrometry: comparison of microwave-based digestion and pressurized ashing systems using different acid mixtures

The effectiveness of different acid mixtures for the de-mineralization of total diet samples of different origin and composition by means of a closed microwave-based technique and a pressurized-ashing technique were investigated. The aim was to obtain complete acid solubilization for the subsequent accurate determination of Al, Ca, Cu, Fe, K, Mg, Na, P and Zn by means of inductively coupled plasma atomic emission spectrometry (ICP-AES). The sampling and sample preparation steps for the trace element analysis are described. The special care taken in the sampling design to ensure the representativeness of the sample for the population studied is also mentioned. The regions and population groups were selected from the high mountain valleys, where a high incidence of stomach cancer exists, and a low altitude valley at the foot of the Andes, which is a low stomach cancer incidence region, both located in the state of Tachira, Venezuela. Total diets including breakfast, lunch, supper, snacks and drinks from the whole-day intake of 140 adults were collected. The collection of the total diet was made according to the double-portion technique. The most reliable digestion procedure for the determination of Al, Ca, Cu, Fe, K, Mg, Na, P and Zn in total diet by means of ICP-AES was a microwave-based technique using HNO3 alone or with the mixture HNO3+ H2O2(2 + 1). In comparison, a pressurized-ashing technique is faster although lower values for K (13 and 11%) were obtained. Despite low sensitivity for the ICP-AES measurements, the microwave-based digestion using HNO3+ H2SO4(4 + 1) also gave good agreement for the determination of Al, Ca, Cu, Fe, K, Mg, Na, P and Zn by means of ICP-AES. Because of the simple and rapid procedure, the pressurized-ashing technique using the mixture HNO3+ H2O2(2 + 1) was selected to perform the digestion of the total diet samples collected. The results of the mean daily intake of the population investigated showed for the high mountain valleys (high stomach cancer incidence area, n= 77) as compared with the low altitude valleys (low stomach cancer incidence area, n= 33) significantly higher daily intake with respect to Na (2082 versus 1471 mg), K (1190 versus 731 mg), P (640 versus 381 mg) and a significantly lower daily intake with respect to Ca (925 versus 1379 mg) and Cu (2.78 versus 4.66 mg). No differences were obtained with respect to Al, Fe, Mg and Zn.

Stomach cancer and work in dusty industries.

The city of Stoke-on-Trent, whose major industries include coalmining, iron and steel, ceramics, and rubber, has death rates from stomach cancer some 80% above the national average. To explore the hypothesis that work in these dusty industries is responsible for the local excess of stomach cancer, we compared 95 incident cases with 190 age and sex matched community controls. Lifetime occupational histories and premorbid consumption of foods suspected of causing or protecting against stomach cancer were ascertained by a self administered questionnaire, supplemented at interview. Sixty eight cases had at some time held a manual job in one of the four dusty industries (relative risk = 1.4, 95% confidence interval 0.8-2.4). After allowance for diet, rubber manufacture was the industry most strongly associated with stomach cancer (relative risk = 2.5, 95% CI 1.0-6.4). Associations were also found with coal mining and ceramics but these were not statistically significant at a 5% level. The estimated proportion of stomach cancer attributable to the four dusty industries was 23%. It is concluded that the high incidence of stomach cancer in Stoke-on-Trent is unlikely to be explained solely by occupational exposure to dust.

Gastric lesions in rats fed salted food materials commonly eaten by Japanese

A high intake of salted food is thought to be related to the high incidence of stomach cancer in Japan. In the present study, female F344 rats were divided into four groups. They were fed a nutritionally deficient purified diet (Group 1) and standard purified diet (Group 3) for 113 weeks and the same diets supplemented with salted cuttlefish guts, broiled, salted, dried sardines, pickled radish, and soy sauce (Groups 2 and 4). The incidence of papillomas and ulcers of the forestomach was highest in Group 4, which was given the standard diet supplemented with the salty food materials (p less than 0.05). These results suggest the importance of salted food as a suspicious causal factor in human stomach cancer in Japan.

Decreasing trend of stomach cancer in Japan.

Stomach cancer is still the most common cancer in both males and females in Japan and the Japanese still show the highest mortality and incidence of stomach cancer in the world. However, the age-adjusted death rate of stomach cancer has shown a marked declining trend in both sexes for the last 25 years in Japan. Advocates of mass screening for stomach cancer and clinicians who specialize in the surgical treatment of stomach cancer may wish to claim credit for the decrease of stomach cancer mortality in Japan whereas advocates of primary prevention of cancer may wish to claim that the decrease of stomach cancer mortality is largely due to a decrease of stomach cancer incidence reflecting a recent change of dietary habits, especially the spread of western-style foods and diminished intake of traditional Japanese foods. In fact, the incidence rate of stomach cancer as estimated from the Osaka Cancer Registry shows a similar decreasing trend to the mortality. In many western countries, notably in the United States, the stomach cancer death rate has been decreasing for a long time, and is still decreasing. In those countries stomach cancer is now ranked as one of the rare cancers. It is hoped that the stomach cancer mortality and incidence will further decrease in the future in Japan in a similar way. Meanwhile, it is necessary to evaluate accurately the effectiveness of stomach cancer screening programs. It is also necessary and useful to explore the reasons for the recent decrease of stomach cancer incidence in Japan, which could be regarded as a "natural experiment" or "passive primary prevention." If we could identify the main reasons for the decrease of stomach cancer incidence from epidemiologic studies, it might be possible to speed-up the decrease of stomach cancer incidence in Japan, as well as in other countries which still show a relatively high incidence of stomach cancer.