Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Eindhoven Cancer Registry, Comprehensive Cancer Centre South, PO Box 231, 5600 AE Eindhoven, The Netherlands.
Cancer Epidemiol. 2014 Feb;38(1):9-15. doi: 10.1016/j.canep.2013.11.001. Epub 2013 Dec 2.
The incidence of gastric cancer declined over the past decades. Recently, unfavorable trend breaks (i.e. rise in incidence) were seen for non-cardia cancer in younger age groups in the US. It is unclear whether these also occur in other Western countries. We aimed to analyze the gastric cancer incidence trends by age, sex, subsite and stage in the Netherlands.
Data on all patients with gastric adenocarcinoma diagnosed from 1973 to 2011 (n=9093) were obtained from the population-based Eindhoven cancer registry. Incidence time trends (European standardized rates per 100,000) were separately analyzed by sex, age group (<60, 60-74, and >75 years), subsite, and pathological stage. Joinpoint analyses were performed to discern trend breaks, age-period-cohort analyses to examine the influence of longitudinal and cross-sectional changes.
The incidence of non-cardia cancer declined annually by 3.5% (95% CI -3.8; -3.3). However, in males <60 years, the incidence flattened since 2006, and tended to rise in those >74 years. This pertained to corpus cancers. The incidence of cardia cancer peaked in 1985 and decreased subsequently by 2.4% (95% CI -3.2; -1.5) yearly. The absolute incidence of stage IV disease at first diagnosis initially decreased, but then remained stable over the past 15-20 years.
The incidence of non-cardia cancer declined over the past four decades in the Netherlands, but now seems to be stabilizing particularly in males. Unfavorable trend breaks are seen for corpus cancer in younger and older males. The trend breaks in the Netherlands are however not similar to those observed in the US.
在过去几十年中，胃癌的发病率有所下降。最近，美国年轻人群中非贲门癌的发病率出现了不利的趋势（即上升）。目前尚不清楚这种情况是否也发生在其他西方国家。我们旨在分析荷兰胃癌发病率的年龄、性别、部位和分期趋势。
从人群基础的埃因霍温癌症登记处获得了 1973 年至 2011 年所有胃腺癌患者（n=9093）的数据。分别按性别、年龄组（<60 岁、60-74 岁和>75 岁）、部位和病理分期分析发病率时间趋势（每 10 万人中的标准化发病率）。使用 Joinpoint 分析来辨别趋势变化，使用年龄-时期-队列分析来检查纵向和横向变化的影响。
非贲门癌的发病率每年下降 3.5%（95%CI-3.8；-3.3）。然而，在男性<60 岁的人群中，自 2006 年以来发病率趋于平稳，而在>74 岁的人群中发病率则有上升趋势。这种情况主要涉及胃体癌。贲门癌的发病率在 1985 年达到峰值，随后每年下降 2.4%（95%CI-3.2；-1.5）。首次诊断时 IV 期疾病的绝对发病率最初下降，但在过去 15-20 年中保持稳定。
在过去的四十年中，荷兰的非贲门癌发病率有所下降，但现在似乎在男性中趋于稳定。在年轻和年老的男性中，胃体癌的发病率出现了不利的趋势变化。然而，荷兰的这些趋势变化与美国观察到的趋势变化并不相似。
