Terry Mary Beth, Gaudet Mia M, Gammon Marilie D
Columbia University Mailman School of Public Health, Department of Epidemiology, New York, NY 10032, USA.
Semin Radiat Oncol. 2002 Apr;12(2):111-27. doi: 10.1053/srao.30814.
The epidemiology of gastric cancer is remarkable for both its dramatic decline in incidence over the past century and its continuing presence as the second leading cause of cancer deaths worldwide despite this decline. Factors including increased consumption of fruits and vegetables, and decreased intake of salty foods have largely been credited for the decline. Epidemiologic studies continue to provide data on other gastric cancer risk factors, including associations with Helicobacter pylori infection, as well as dietary factors, tobacco, and alcohol intake. In response to the opposing trends of decreasing distal gastric cancer and increasing gastric cardia adenocarcinoma, studies are beginning to identify gastric cancer risk factors separately by tumor subsite. Future epidemiologic studies that include information on site of origin as well as molecular markers promise to yield more homogeneous classification of case groups, which will enhance identification of underlying disease processes.
胃癌的流行病学特征显著，一方面在过去一个世纪其发病率急剧下降，另一方面尽管有此下降趋势，它仍是全球癌症死亡的第二大主要原因。水果和蔬菜摄入量增加以及咸食摄入量减少等因素在很大程度上被认为是发病率下降的原因。流行病学研究继续提供有关其他胃癌风险因素的数据，包括与幽门螺杆菌感染的关联以及饮食因素、烟草和酒精摄入量。针对远端胃癌减少和贲门腺癌增加的相反趋势，研究开始按肿瘤亚部位分别确定胃癌风险因素。未来的流行病学研究若纳入起源部位信息以及分子标记，有望对病例组进行更同质化的分类，这将加强对潜在疾病过程的识别。
