Kelley Jon R, Duggan John M
Department of Veterans' Affairs, Commonwealth of Australia, G.P.O. Box 651, Brisbane, Queensland 4001, Australia.
J Clin Epidemiol. 2003 Jan;56(1):1-9. doi: 10.1016/s0895-4356(02)00534-6.
We performed a detailed analysis of the epidemiology of gastric carcinoma, based upon a review of the literature in English. The analysis reveals many puzzling features. There has been a steady fall in the incidence of gastric carcinoma in most societies studied, but a more recent steady rise in the incidence of adenocarcinoma of the cardia and lower esophagus, largely confined to White males. Although the evidence for a major role for Helicobacter pylori (H. pylori) in the etiology of gastric corpus cancer is compelling; in Western society, it probably accounts for fewer than half the cases. The relative roles of dietary constituents such as salt and nitrites and the phenotyping of H. pylori in causation and the beneficial effects of a high fruit and vegetable diet and an affluent lifestyle, for all of which there is some evidence, are yet to be quantified.
我们基于对英文文献的综述，对胃癌流行病学进行了详细分析。该分析揭示了许多令人困惑的特征。在大多数研究的社会群体中，胃癌发病率一直在稳步下降，但贲门和食管下段腺癌的发病率最近却在稳步上升，且主要限于白人男性。尽管幽门螺杆菌（H. pylori）在胃体癌病因中起主要作用的证据确凿；但在西方社会，它可能导致的病例不到一半。饮食成分如盐和亚硝酸盐的相对作用、幽门螺杆菌的表型在病因中的作用，以及高水果和蔬菜饮食及富裕生活方式的有益影响，所有这些都有一些证据，但尚未量化。
