Merchant Shaila J, Kim Joseph, Choi Audrey H, Sun Virginia, Chao Joseph, Nelson Rebecca
Division of Surgical Oncology, Queen's University, Kingston, ON, Canada.
Division of Surgical Oncology, Stony Brook Medicine, Stony Brook, NY, USA.
Gastric Cancer. 2017 Mar;20(2):226-234. doi: 10.1007/s10120-016-0603-7. Epub 2016 Feb 29.
Although the incidence of gastric cancer has been decreasing, recent reports suggest an increased rate in select populations. We sought to evaluate trends in gastric cancer incidence to identify high-risk populations.
Gastric cancer incidence rates from 1992 to 2011 were computed with use of the Surveillance, Epidemiology, and End Results (SEER) registry. We evaluated trends in incidence rates by calculating the annual percent change (APC) across three age groups (20-49 years, 50-64 years, and 65 years or older) and four racial/ethnic groups (Hispanics, non-Hispanic whites, blacks, and Asian/Pacific Islanders).
We identified 41,428 patients with gastric cancer. For the entire cohort during the study period, the APC was decreased. When patients were grouped according to sex, the APC was flat or decreased in women regardless of age or race/ethnicity. The APC was also flat or decreased for all men except young Hispanic men (20-49 years), who had an increased APC of nearly 1.6 % (1.55 %, 95 % confidence interval 0.26-2.86 %). Furthermore, young Hispanic men were the only group to have increased incidence of stage IV disease (APC 4.34 %, 95 % confidence interval 2.76-5.94 %) and poorly differentiated tumors (APC 2.08 %, 95 % confidence interval 0.48-3.70 %).
The APC of the incidence of gastric cancer in young Hispanic men places it among the top cancers with rising incidence in the USA. This is concomitant with increased incidence of advanced disease at presentation. This major public health concern warrants additional research to determine the cause of the increasing incidence in this group.
尽管胃癌的发病率一直在下降,但最近的报告显示特定人群中的发病率有所上升。我们试图评估胃癌发病率的趋势以确定高危人群。
利用监测、流行病学和最终结果(SEER)登记系统计算1992年至2011年的胃癌发病率。我们通过计算三个年龄组(20 - 49岁、50 - 64岁和65岁及以上)和四个种族/族裔组(西班牙裔、非西班牙裔白人、黑人以及亚裔/太平洋岛民)的年度百分比变化(APC)来评估发病率趋势。
我们确定了41428例胃癌患者。在研究期间,整个队列的APC呈下降趋势。当按性别分组时,无论年龄或种族/族裔如何,女性的APC持平或下降。除年轻西班牙裔男性(20 - 49岁)外,所有男性的APC也持平或下降,年轻西班牙裔男性的APC增加了近1.6%(1.55%,95%置信区间0.26 - 2.86%)。此外,年轻西班牙裔男性是唯一IV期疾病发病率增加(APC 4.34%,95%置信区间2.76 - 5.94%)和低分化肿瘤发病率增加(APC 2.08%,95%置信区间0.48 - 3.70%)的群体。
年轻西班牙裔男性胃癌发病率的APC使其成为美国发病率上升的主要癌症之一。这与就诊时晚期疾病发病率增加相伴。这一重大公共卫生问题值得进一步研究以确定该群体发病率增加的原因。