a Department of Hematology and Oncology , Institute of Clinical Medicine, University of Tartu , Tartu , Estonia.
b Department of Epidemiology and Biostatistics , National Institute for Health Development , Tallinn , Estonia.
Acta Oncol. 2019 Mar;58(3):283-289. doi: 10.1080/0284186X.2018.1546058. Epub 2019 Jan 11.
Gastric cancer (GC) is among the most common cancers and one of the leading causes of cancer deaths globally. In general, the incidence of GC has declined and survival improved in Europe. Nevertheless, previous analysis has shown that survival of GC patients in Estonia is still significantly lower compared to some European countries. Therefore, to improve patient outcomes, better overview of GC epidemiology is needed. The aim of this study was to describe the incidence and survival of GC in Estonia 1995-2014 in relation to age, subsite, morphology, and the extent of disease.
We used data from the population-based Estonian Cancer Registry on all incident cases of GC diagnosed in 1995-2014. Incidence rates and relative survival were calculated. Joinpoint regression modeling was used to estimate annual percentage change for incidence trends. Data were analyzed by age, sex, subsite, morphology, and the extent of disease. Changes between 1995-1999 and 2010-2014 were assessed.
The overall incidence of GC in Estonia decreased in 1995-2014. The age-standardized (world) incidence declined significantly for both sexes, for patients below 70 years of age, adenocarcinomas, NOS and other morphologies, non-cardia and unspecified cases, and for all known stages. Approximately 40% of GC cases were diagnosed with distant metastasis. Overall age-standardized 5-year relative survival of GC patients increased from 20% to 28%. Survival improved the most in age group 50-69 years. A large survival gain was also seen for localized (from 55% to 70%) and locally/regionally spread disease (from 23% to 37%).
In Estonia, the incidence of GC has declined and relative survival increased. However, special emphasis needs to be put on improving survival among men, elderly and in patients with metastatic disease.
胃癌（GC）是最常见的癌症之一，也是全球癌症死亡的主要原因之一。总体而言，欧洲的 GC 发病率下降，生存率提高。然而，先前的分析表明，与一些欧洲国家相比，爱沙尼亚 GC 患者的生存率仍然明显较低。因此，为了改善患者的预后，需要更好地了解 GC 的流行病学情况。本研究旨在描述 1995-2014 年爱沙尼亚 GC 的发病率和生存率与年龄、部位、形态和疾病程度的关系。
我们使用基于人群的爱沙尼亚癌症登记处的数据，该数据涵盖了 1995-2014 年期间所有确诊的 GC 病例。计算了发病率和相对生存率。使用 Joinpoint 回归模型估计发病率趋势的年百分比变化。按年龄、性别、部位、形态和疾病程度进行数据分析。评估了 1995-1999 年与 2010-2014 年之间的变化。
1995-2014 年，爱沙尼亚的 GC 总发病率下降。男女两性、70 岁以下患者、腺癌、NOS 和其他形态、非贲门和未特指部位以及所有已知分期的年龄标准化（世界）发病率均显著下降。约 40%的 GC 病例诊断为远处转移。GC 患者的总体年龄标准化 5 年相对生存率从 20%增加到 28%。50-69 岁年龄组的生存率提高最多。局限性（从 55%到 70%）和局部/区域扩散性疾病（从 23%到 37%）的生存率也有显著提高。
在爱沙尼亚，GC 的发病率下降，生存率提高。然而，需要特别关注改善男性、老年人和转移性疾病患者的生存率。
