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Review
. 2017 Aug;19(8):36.
doi: 10.1007/s11894-017-0575-8.

Changing Trends in Stomach Cancer Throughout the World

Maya Balakrishnan  1 , Rollin George  1 , Ashish Sharma  1 , David Y Graham  2   3
Affiliations
Review

Changing Trends in Stomach Cancer Throughout the World

Maya Balakrishnan et al. Curr Gastroenterol Rep. 2017 Aug.

Abstract

Purpose of review: The paper aims to discuss the global trends in gastric cancer incidence in relation to important factors involved in the pathogenesis of gastric cancer.

Recent findings: Despite a significant worldwide decline, gastric cancer remains a common cause of cancer death. The decline has been multifactorial and preceded the fall in Helicobacter pylori prevalence. The initial decline was associated with changes in food preservation and availability, especially of fresh fruits and vegetables, followed by a decline in the primary etiologic factor, H. pylori. Gastric cancer incidence remains high in East Asia, intermediate in Latin America, and low in developed countries. Significant racial/ethnic variability exists. The rapid decline in incidence in East Asia will continue as primary and secondary prevention strategies are implemented. The incidence in Latin America is unlikely to decline significantly over the next few decades given high H. pylori prevalence in the young. Ultimately, global H. pylori eradication will be needed to largely eliminate gastric cancer.

Keywords: Disparities; Epidemiology; Gastric cancer; Helicobacter pylori; Natural history; Risk factors.

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Conflict of interest statement

Conflict of Interest Ashish Sharma, Maya Balakrishnan, and Rollin George declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Changes in H. pylori prevalence among an asymptomatic White US population. Data from reference [71] for the birth cohorts born between 1916 and 1976, the data before and after, are estimated. The plot illustrates that until the late 1800s, most adults have H. pylori infection and atrophic gastritis. Late in the 1800s, the pattern of gastritis and the most common H. pylori-related disease changed from atrophic gastritis, gastric ulcer, and gastric cancer to a non-atrophic duodenal ulcer pattern and then with further decline in H. pylori prevalence, all H. pylori-related diseases tended to disappear
Fig. 2
Fig. 2
Mean ± 95% confidence intervals of atrophy and intestinal metaplasia scores of corpus mucosal biopsies in H. pylori-positive patients according to age group. Both mucosal atrophy and metaplasia in the corpus significantly decreased in time period setting in all age group and comparisons between all subgroups were significant (p < 0.05). Note the age-related increase between groups but the time-related decrease within groups. From reference [63••], with permission from John Wiley and Sons.
Fig. 3
Fig. 3
Changes in the incidence of gastric cancer and H. pylori infection among Japanese men aged 65–69 during the latter half of the twentieth century. Data from reference [64••]. Figure from reference [65•], with permission from Elsevier
See this image and copyright information in PMC

References

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      Global consensus on gastritis which discusses classification of chronic gastritis and duodenitis and defines H. pylori infection as an infectious disease that should be cured whenever encountered.

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