Trends In Gastric Cancer Mortality Research Articles

Trends in Gastric Cancer Mortality in Montenegro, 1990–2018: Joinpoint Regression

Introduction: Gastric cancer (GC) remains a significant global public health problem, despite the decreasing trends in GC mortality rates in the last 5 decades. Our study aimed to examine the pattern of GC mortality in Montenegro between 1990 and 2018 and to contribute to the future by designing a national long-term strategy for the control and prevention of GC. Methods: Gastric cancer mortality data in Montenegro from 1990 to 2018 were collected. Mortality rates were age-standardized to the World Standard Population for estimating both the overall and gender-specific trends. The joinpoint regression model was used to assess GC mortality and identified significant changes in the linear time trend. Linear and Poisson regressions were also applied for additional trend analyses. Results: Joinpoint regression reveals a statistically significant decrease in the age-standardized rate for the overall level, on average by 1.4% per year (AAPC [95% IP] = −1.4 [−2.4 to −0.4]; p = 0.007), which was due to a decrease in the age-standardized rate in men with an average annual change of −1.8% (AAPC [95% IP] = −1.8 [−2.9 to −0.6]; p = 0.003), while in women the rates were stable (p = 0.565). The results for age groups indicate that a decline was registered at the overall level, and among men, as a consequence of the trend of decreasing age-specific rates for the age group 55–64 on average annually by 2% among men (AAPC [95% IP] = −2 [−3.8 to −0.1]; p = 0.035), and for the overall level (AAPC [95% IP] = −2 [−3.7 to −0.3]; p = 0.026). Conclusion: Our findings indicate a noteworthy decline in age-standardized overall GC mortality rates among men in Montenegro, while rates for women have remained constant. National strategies to further reduce mortality rates for GC are necessary.

Trends in gastric cancer mortality 2005–2020 in Peru and its geographical areas: A joinpoint regression analysis

BackgroundGastric cancer (GC) is the leading cause of cancer death in Peru. However, information regarding trends in mortality rates in Peru and its geographical areas in the last few decades is lacking. Our objective was to describe GC mortality rates in Peru between 2005 and 2020. MethodsAge standardized mortality rates (ASMR) were calculated per 100,000 person-years using the world SEGI standard population. Joinpoint regression analysis was performed to examine mortality trends. The analysis of the last 5 years was performed for Peru and its geographical areas. ResultsGC mortality rates in 2005 and in 2020 were 13.81 and 10.52, respectively, for men and 11.81 and 8.06, respectively, for women. Between 2016 and 2020, Huanuco and Huancavelica reported the highest mortality rates (≥20 deaths per 100,000). In men, Peru and the highlands region reported significant decreases in GC mortality rates in both sexes for some periods. Coastal region significant decreased by 2.6 % in all periods for women. In both sexes, six provinces reported significant decreases in GC mortality rates. ConclusionAlthough GC mortality rates in Peru have declined over the past 16 years. They are still one of the highest in the Latin American and Caribbean region. It is important that the Peruvian State seek to reduce the mortality of this disease through prevention efforts, timely detection and treatment in all patients.

Decline of gastric cancer mortality in common variable immunodeficiency in the years 2018-2022.

In patients with Common Variable Immunodeficiency, malignancy has been reported as the leading cause of death in adults, with a high risk of B-cell lymphomas and gastric cancer. We conducted a five-year prospective study aiming to update the incidence and mortality of gastric cancer and the incidence of gastric precancerous lesions in 512 CVID patients who underwent a total of 400 upper gastrointestinal endoscopies. In the pre-pandemic period, 0.58 endoscopies were performed per patient/year and in the COVID-19 period, 0.39 endoscopies were performed per patient/year. Histology revealed areas with precancerous lesions in about a third of patients. Patients who had more than one gastroscopy during the study period were more likely to have precancerous lesions. Two patients received a diagnosis of gastric cancer in the absence of Helicobacter pylori infection. The overall prevalence of Helicobacter pylori infection in biopsy specimens was 19.8% and related only to active gastritis. Among patients who had repeated gastroscopies, about 20% progressed to precancerous lesions, mostly independent of Helicobacter pylori. While gastric cancer accounted for one in five deaths from CVID in our previous survey, no gastric cancer deaths were recorded in the past five years, likely consistent with the decline in stomach cancer mortality observed in the general population. However, during the COVID-19 pandemic, cancer screening has been delayed. Whether such a delay or true decline could be the reason for the lack of gastric cancer detection seen in CVID may become clear in the coming years. Due to the high incidence of precancerous lesions, we cannot rely on observed and predicted trends in gastric cancer mortality and strongly recommend tailored surveillance programs.

Trends in gastric cancer mortality 1990-2019 in 36 countries worldwide, with predictions to 2025, and incidence, overall and by subtype.

Gastric cancer (GC) incidence is declining heterogeneously worldwide. We aimed to calculate updated mortality trends for GC. We investigated time trends for selected countries using the World Health Organization database. We computed age-standardized mortality rates (ASMR) per 100,000 persons over the 1990-2019 period. We reported rates for the 2010-2014 and 2015-19 calendar periods, and the corresponding percent changes. We used joinpoint regression analysis to identify changes in the slope of mortality trends, and predict the number of deaths and rates for 2025. We also reported 2008-2012 incidence rates of cardia and noncardia GC. Mortality trends from GC have been favorable since 1990 for all countries analyzed and the European Union (EU 27), in both sexes and all ages. GC mortality is predicted to decline in all countries for both sexes, except for French and US women aged 35-64 years, and Canadian men aged 35-64. The highest proportions of cardia GC were observed in Northern and Central Europe while the lowest ones in Southern and Eastern Europe. Elsewhere, the highest proportions were registered in countries with low incidence and mortality rates, whereas high-mortality countries showed lower proportions of cardia GC. Observed and predicted GC mortality trends declined in most countries in both sexes, with few exceptions, likely due to the control of GC risk factors, in particular Hp infection.

Trend in Gastric Cancer Mortality in Kazakhstan.

The aim is to study the trends in gastric cancer (GC) mortality in Kazakhstan. Data on those who died from GC and on the annual population were obtained from the Bureau of National Statistics of the Agency for Strategic Planning and Reforms of the Republic of Kazakhstan. A retrospective study was carried out for the period 2009-2018 using descriptive and analytical methods of oncoepidemiology. The extensive, crude and age-specific mortality rates are determined according to the generally accepted methodology used in sanitary statistics. GC mortality in Kazakhstan is considered to be decreasing. It was determined that during the studied period 19,672 died of this cancer. The mean of death was 67.8 with 95% CI of 67.6 to 68.0. The highest mortality rates per 100,000 in the entire population were found in the age groups 75-79 years (145.9±24.1), 80-84 years (161.0±11.0), and 85+ years (116.5±16.4). Trends in age-related mortality rates had a pronounced tendency to increase in 70-74 years (T=+4.3%, R2=0.1924) and to decrease in the age of up to 30 (T=-8.7%, R2=0.2426). The average annual standardized mortality rate was 13.2 per 100,000, and in trends tended to decrease (T=-5.8%; R2=0.9763). In all regions, there is a decrease in mortality, except for the city of Astana. During categorization mortality rates were determined on the basis of standardized indicators: low - up to 12.9, average - from 12.9 to 15.1, high - above 15.1 per 100,000 for the entire population. The mortality rates from GC tend to decrease, while the downward trends and the degree of their approximation are expressed in almost all regions. The study of regional mortality has theoretical and practical significance for monitoring and evaluating the effectiveness of early detection and treatment. Health authorities should take into account the results obtained when organizing antitumor measures.

Gastric Cancer Mortality Trends in the Southern Cone: Disentangling age, period and cohort patterns in Argentina and Chile

Although Argentina and Chile are neighboring countries, gastric cancer (GC) is the first cancer death cause in the Chilean male population, while it is ranked in fifth place for Argentinean males. This study is the first to identify the differential time-patterns associated with the age-period-cohort effects for the last few decades (1990–2015) in these Southern Cone countries. Trends of age-standardized truncated mortality rates (ASMR) for GC were analyzed using log-linear Poisson age-period-cohort models, including cubic splines for each component. The ASMR trends for GC decreased in both sexes but more considerably in Chile and more favorably for males (annual percentage changes 2002–2015 = −3.5, 95%CI: −3.9 to −3.1). Moreover, GC age-specific mortality rates were noticeably higher in Chile. A favorable decreasing mortality risk throughout the periods (from 2000) and by cohort was observed for both countries; however, the risk reduction has stabilized in younger female cohorts since 1950-cohort. In conclusion, overall favorable decreasing trends for GC mortality were found; however, when age-period-cohort effects were disentangled, Chile and younger female cohorts showed a more unfavorable scenario. Obesity, lifestyles, and environmental conditions (like altitude) may explain country differences. This analytical approach may be a valuable tool to be replicated in other countries with no population-based cancer registries and acceptable mortality data quality.

Gastric Cancer Mortality Trends in China (2006-2013) Reveal Increasing Mortality in Young Subjects

Although the advent of Helicobacter pylori eradication and global societal changes are widely assumed to impact on gastric cancer (GC)-related mortality, there is remarkable little quantitative and qualitative insight into the nature of its effects. Here, we exploited a nationwide reporting system to investigate the epidemiological features of GC-related mortality in China between 2006 and 2013. GC mortality data between 2006 and 2013 were obtained from the National Disease Surveillance System published by the China Center for Disease Control and Prevention (CDC). GC mortality increased by 8.2% (from 18.87/100,000 to 20.41/100,000), while GC mortality standardized by the age scale of the population in 2010 decreased by 17.8% (from 21.87/100,000 to 17.98/100,000). Standardized GC mortality in males (25.66/100,000 to 33.89/100,000) was higher compared to females (10.72/100,000 to 14.79/100,000), while standardized GC mortality in rural areas (19.17/100,000 to 26.46/100,000) was higher than in urban areas (15.48/100,000 to 20.04/100,000). Both crude and standardized rates in the 0- to 29-year-old group increased by 22.3% and 16.2%, respectively; while these rates declined in the 30- to 59-year-old group and over 60-year-old group. The proportion of GC deaths that accounts for all cancer deaths declined from 15.99% (2006) to 13.6% (2013); however, the proportion in the 0- to 29-year-old group revealed an increasing trend from 2006 (3.20%) to 2013 (3.87%). Our results reveal a remarkable increase in GC-related mortality in subjects under the age of 30 calling for further measures to prevent the increase in the incidence of GC in young patients.

Trends in gastric cancer mortality and in the prevalence of Helicobacter pylori infection in Portugal.

Portugal has the highest gastric cancer mortality rates in Western Europe, along with high prevalences of Helicobacter pylori infection. Monitoring their trends is essential to predict the burden of this cancer. We aimed to quantify time trends in gastric cancer mortality in Portugal and in each administrative region, and to compute short-term predictions, as well as to describe the prevalence of H. pylori infection, through a systematic review. Joinpoint analyses were used to identify significant changes in sex-specific trends in gastric cancer age-standardized mortality rates (ASMR) and to estimate annual percent changes (APC). The most recent trends were considered to compute estimates up to 2020 by adjusting Poisson regression models. We searched PubMed and IndexRMP to identify studies carried out in Portugal reporting the prevalence of H. pylori. Gastric cancer mortality has been decreasing in Portugal since 1971 in men (from ASMR=55.3/100 000; APC=-2.4, 95% confidence interval: -2.5 to -2.3) and since 1970 in women (from ASMR=28.0/100 000; APC=-2.8, 95% confidence interval: -2.9 to -2.7), although large regional differences were observed. Predicted ASMR for 2015 and 2020 were 18.8/100 000 and 16.7/100 000 for men and 8.5/100 000 and 7.4/100 000 for women, respectively. The prevalence of H. pylori varied from almost 5% at 0.5-2 years to just over 90% at 70 years or more. No consistent variation was observed since the 1990s. The downward trends in mortality rates are expected to remain in the next decades. The high prevalence of H. pylori infection across age groups and studies from different periods shows a large potential for decrease in the burden of gastric cancer in Portugal.

Efficient estimation for the conditional autoregressive model

Recently, spatial regression models have been attracting a great deal of attention in areas ranging from effect of traffic congestion on accident rates to the analysis of trends in gastric cancer mortality. In this paper, we propose efficient estimators for the regression coefficients of the spatial conditional autoregressive model, when uncertain auxiliary information is available about these coefficients. We provide efficiency comparisons of the proposed estimators based on asymptotic risk analysis and Monte Carlo simulations. We apply the proposed methods to real data on Boston housing prices and illustrate how a bootstrapping approach can be employed to compute prediction errors of the estimators.

Worldwide trends in gastric cancer mortality (1980–2011), with predictions to 2015, and incidence by subtype

Gastric cancer incidence and mortality decreased substantially over the last decades in most countries worldwide, with differences in the trends and distribution of the main topographies across regions. To monitor recent mortality trends (1980–2011) and to compute short-term predictions (2015) of gastric cancer mortality in selected countries worldwide, we analysed mortality data provided by the World Health Organization. We also analysed incidence of cardia and non-cardia cancers using data from Cancer Incidence in Five Continents (2003–2007). The joinpoint regression over the most recent calendar periods gave estimated annual percent changes (EAPC) around −3% for the European Union (EU) and major European countries, as well as in Japan and Korea, and around −2% in North America and major Latin American countries. In the United States of America (USA), EU and other major countries worldwide, the EAPC, however, were lower than in previous years. The predictions for 2015 show that a levelling off of rates is expected in the USA and a few other countries. The relative contribution of cardia and non-cardia gastric cancers to the overall number of cases varies widely, with a generally higher proportion of cardia cancers in countries with lower gastric cancer incidence and mortality rates (e.g. the USA, Canada and Denmark). Despite the favourable mortality trends worldwide, in some countries the declines are becoming less marked. There still is the need to control Helicobacter pylori infection and other risk factors, as well as to improve diagnosis and management, to further reduce the burden of gastric cancer.

Spatio-temporal trends in gastric cancer mortality in Spain: 1975–2008

Aim of the study: There has been a downward trend in gastric cancer mortality worldwide. In Spain, a marked spatial aggregation of areas with excess mortality due to this cause has long been reported. This paper sought to analyse the evolution of gastric cancer mortality risk in Spanish provinces and explore the possible attenuation of the geographical pattern. Methods: We studied a series of gastric cancer mortality data by province, year of death, sex and age group using a conditional autoregressive (CAR) model that incorporated space, time and spatio-temporal interactions. Results: Gastric cancer mortality risk decreased in all Spanish provinces in both males and females. Overall, decreasing trends were more pronounced during the first years of the study period, largely due to a sharper fall in gastric cancer mortality risk among the older population. Recent decades have witnessed a slowing in the rate of decrease, especially among the younger age groups. In most areas, risk declined at a similar rate, thus serving to maintain interprovincial differences and the persistence of the geographical pattern, though with some differences. The north and northwest provinces were the areas with higher mortality risks in both sexes and age groups over the entire study period. Concluding statement: Despite the decline in gastric cancer mortality risk observed for the 50 Spanish provinces studied, geographical differences still persist in Spain, and the cluster of excess mortality in the north-west of the country remains in evidence.

Diabetes conveys a higher risk of gastric cancer mortality despite an age-standardised decreasing trend in the general population in Taiwan

BackgroundThe association between diabetes and gastric cancer has been rarely studied.ObjectiveTo investigate gastric cancer mortality trends, the mortality rate ratios between patients with diabetes and the general population, and the...

Gastric cancer mortality trends in Spain, 1976-2005, differences by autonomous region and sex.

BackgroundGastric cancer is the second leading cause of oncologic death worldwide. One of the most noteworthy characteristics of this tumor's epidemiology is the marked decline reported in its incidence and mortality in almost every part of the globe in recent decades. This study sought to describe gastric cancer mortality time trends in Spain's regions for both sexes.MethodsMortality data for the period 1976 through 2005 were obtained from the Spanish National Statistics Institute. Cases were identified using the International Classification of Diseases 9th and 10th revision (codes 151 and C16, respectively). Crude and standardized mortality rates were calculated by geographic area, sex, and five-year period. Joinpoint regression analyses were performed to ascertain whether changes in gastric cancer mortality trends had occurred, and to estimate the annual percent change by sex and geographic area.ResultsGastric cancer mortality decreased across the study period, with the downward trend being most pronounced in women and in certain regions situated in the interior and north of mainland Spain. Across the study period, there was an overall decrease of 2.90% per annum among men and 3.65% per annum among women. Generally, regions in which the rate of decline was sharpest were those that had initially registered the highest rates. However, the rate of decline was not constant throughout the study period: joinpoint analysis detected a shift in trend for both sexes in the early 1980s.ConclusionGastric cancer mortality displayed in both sexes a downward trend during the study period, both nationally and regionally. The different trend in rates in the respective geographic areas translated as greater regional homogeneity in gastric cancer mortality by the end of the study period. In contrast, rates in women fell more than did those in men. The increasing differences between the sexes could indicate that some risk factors may be modifying the sex-specific pattern of this tumor.

Gastric Cancer Mortality Trends in Tuscany, Italy, 1971–2004

AIMS, BACKGROUND, AND METHODS: In Tuscany, Italy, gastric cancer mortality has been decreasing since 1950, although with relevant geographical variability across the region. In Eastern Tuscan areas close to the mountains (high risk areas), gastric cancer mortality has been and is still significantly higher than that recorded in Western coastal areas and in the city of Florence (low risk areas). High-risk areas also showed higher Helicobacter pylori seroprevalence. Aim of this paper is to study gastric cancer mortality trends in high and low-risk areas, during the period 1971-2004, using age-period-cohort models. In high-risk areas, gastric cancer mortality rates declined from 61.4 per 100,000 in 1971-74 to 19.8 in 2000-2004 and in low-risk areas from 34.9 to 9.8. Mortality decline in high-risk areas was mainly attributable to a birth cohort effect, whereas in low-risk areas it was due either to a birth cohort effect or a period effect. In low- and high-risk areas, birth-cohort risks of dying decreased over subsequent generations, except for the birth cohorts born around the second world war. Gastric cancer mortality in areas with higher H. pylori seroprevalence in Tuscany (high-risk areas) showed a predominant decline by birth cohort, in particular for younger generations, possibly due to the decrease of the infection for improvement of living conditions.

Regional trends in Portuguese gastric cancer mortality (1984–1999)

The international decline in gastric cancer is mainly attributed to improved socio-economic conditions. However, some southern and eastern European countries showed slower and later decline, reflecting a less favourable general environment The same probably applies to regional differences within countries, making national indicators potentially misleading. Fitting log-linear Poisson models we compared trends in gastric cancer mortality (1984-1999) across 18 Portuguese regions. Pearson correlation coefficients were computed to assess the regional association between decline in cancer mortality and baseline cancer mortality and variation in indices of social development and medical care. National gastric cancer mortality changed -2.0% year in men and -2.2% year in women. The regional yearly variation in mortality ranged from -3.5% [95% confidence interval (CI) -4.5 to -2.5] to -0.6% (95% CI -1.4 to 0.2) in men, and from -3.7% (95% CI -4.8 to -2.7) to -0.8% (95% CI -1.6 to 0.0) in women. Regional variation was not significantly associated with baseline gastric cancer mortality (r = 0.18, P = 0.47), but with the variation in post-neonatal mortality (r = 0.59, P = 0.01). In Portugal, gastric cancer shows a wide regional variation in frequency trends. The correlation with known indicators of social and economic development indicates that future improvement in gastric cancer rates is expected in parallel with a more widespread development.

Gastric cancer in the European Union (1968–1992): Mortality trends and cohort effect

PURPOSE: To analyze patterns and trends in gastric cancer mortality in the European Union (EU) over the period 1968–1992, paying special attention to changes associated with birth cohort. METHODS: Poisson log-linear models were used to quantify geographic differences and relative annual changes. To assess trends associated with birth cohort, invariant parameters from sex-specific age-periodcohort models (net drift and curvature), for each country, were used to choose a restricted slope range for cohort effect. RESULTS: Gastric cancer mortality declined throughout the EU. The male-to-female ratio stood at around 2 in all countries, yet showed a slight rise over time. Portugal reported the highest age-adjusted rates for men and women (45.63 and 23.31 per 100,000 person-years, respectively). The rate ratio between two extreme countries (Portugal/Denmark) exceeded 3. Quantitative intercountry differences were found in trend slopes, with a decrease of 5% per annum in Finland. Risk of dying associated with birth cohort decreased over successive generations. Small local rises in risk, in almost all countries among generations born around the 1940s, support the importance of diet early in life in the etiology of gastric cancer. CONCLUSIONS: Despite the substantial decline in gastric cancer mortality witnessed in the EU, stress must be accounted for the wide differences among countries and the smaller decline in the youngest generations, particularly among women. This latter finding suggests a possible stabilization or even a rise in the rates in future, rendering it important for these trends to be monitored over the next few years.

Increased faecal mucin sulphatase activity in ulcerative colitis: a potential target for treatment.

Colonic mucin is heavily sulphated and it has been shown that enzymatic desulphation by faecal bacterial sulphatases greatly increases its susceptibility to degradation by faecal glycosidases. A possible role for faecal mucin sulphatase in the pathogenesis of inflammatory bowel disease has therefore been explored. Faecal mucin sulphatase activity assayed using 35S mucin as substrate was increased in ulcerative colitis (median 80.2 units/g pellet weight (range 6.9-1063; 95% confidence intervals (CI): 45.2 to 293.8, n = 22) compared with 11.3 units/g (range 3.0-53.5; 95% CI: 8.7 to 29.8, n = 17) in healthy controls (p < 0.01), where one unit released 1000 dpm free sulphate/hour from 35S mucin (1680 dpm/microgram). Patients with active ulcerative colitis had higher sulphatase activity (median 146; 95% CI: 98 to 253 units/g, n = 10) than those with inactive ulcerative colitis (median 42.2; CI: 22.5 to 81.6 units/g, n = 12) (p < 0.05). Longitudinal studies in patients with ulcerative colitis show fluctuations of faecal mucin sulphatase activity corresponding to clinical disease activity in six of seven patients. Faecal mucin sulphatase activity was not significantly increased in Crohn's disease (median 36.6, range 5.7-106.6; 95% CI: 22.9 to 65.3 units/g, n = 14). The bismuth salts, bismuth subcitrate and bismuth subsalicylate were found to inhibit faecal mucin sulphatase activity at concentrations achievable therapeutically. The increased faecal mucin sulphatase activity in ulcerative colitis could be the result of greater intraluminal substrate (mucin) availability leading to bacterial enzyme induction, but would probably result in more rapid degradation of secreted mucin and represents a potential target for treatment.

Health aspects of nitrate in drinking water

This paper reviews the health aspects of nitrate in drinking water with particular reference to methaemoglobinaemia and carcinogenic risk. It examines regional trends in gastric cancer mortality in England and Wales in relation to nitrogenous fertiliser usage, and mortality from gastric cancer in rural districts in eastern England in relation to nitrate concentrations in public water supplies.