West Kazakhstan Marat Ospanov Medical University, 68, Maresyev Street, Aktobe, Kazakhstan.
Tbilisi State Medical University, 33, Vazha-Pshavela Ave., Tbilisi, Georgia.
Asian Pac J Cancer Prev. 2020 Jun 1;21(6):1645-1652. doi: 10.31557/APJCP.2020.21.6.1645.
to assess the current state of gastric cancer (GC) incidence and its five-year survival across Aktobe region of western Kazakhstan from 2009 to 2018 by presenting key indicators and analyzing the most significant features.
Rough incidence rates (per 100,000) and average annual percent changes (aAPCs) were estimated for each age group at diagnosis with respect to gender, ethnicity, residence, the disease stages, tumor subsite, and histology type using linear regression analysis, including the prognostic index for 2019-2020. Overall five-year survival rates were estimated by the Kaplan-Meier method.
Overall GC incidence increased from 19.2 to 29.3, and averaged 25.8 (R2 0.65) with aAPC of 3.2%, with a potential to further rise (30.4 by 2020, p<0.001). Non-cardia location (17.8, p<0.001, aAPC 6.4%) and intestinal type of the tumor (17.0, p<0.001, aAPC 7.35%) were predominant. The observed overall five-year survival rate was 28.4% (95% CI 24.5;32.3) with a median survival time of 8.0 months (95% CI 6.6;9.4). Groups aged 40-49 and ≥70 had the lowest rates (24.4% and 22.1%, respectively, log-rank p 0.008), but the youngest individuals (18-39 years) showed the shortest median survival time, 5.0 months after diagnosis at the survival rate of 29.4%. Resectional surgery contributed significantly to the median survival time, 23.0 months vs. 6.0 in non-operated patients (log-rank p<0.001).
GC in Aktobe region was featured by growing incidence and unsatisfactory five-year survival rates. Indigenous males of 60-69 years old with intestinal histology type, as well as the youngest patients irrespective of their gender, ethnicity, and other characteristics were recognized as high risk groups. Besides, relatively high aAPC 5.1% in the youngest revealed their further expected vulnerability. Further research is suggested to focus on risk factors, including gene expression profiling, to find out an accessible preventive strategy.
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通过呈现关键指标并分析最重要的特征，评估 2009 年至 2018 年哈萨克斯坦西部阿克托贝地区胃癌（GC）的发病情况及其五年生存率。
使用线性回归分析，按性别、种族、居住地、疾病分期、肿瘤部位和组织学类型，对每个诊断年龄组的粗略发病率（每 10 万人）和平均年百分比变化（aAPC）进行估计，包括 2019-2020 年的预后指数。使用 Kaplan-Meier 方法估计总体五年生存率。
GC 的总发病率从 19.2 增加到 29.3，平均为 25.8（R2 0.65），aAPC 为 3.2%，有进一步上升的趋势（2020 年为 30.4，p<0.001）。非贲门部位（17.8，p<0.001，aAPC 6.4%）和肠型肿瘤（17.0，p<0.001，aAPC 7.35%）占主导地位。观察到的总体五年生存率为 28.4%（95%CI 24.5;32.3），中位生存时间为 8.0 个月（95%CI 6.6;9.4）。40-49 岁和≥70 岁的人群的生存率最低（分别为 24.4%和 22.1%，log-rank p 0.008），但最年轻的个体（18-39 岁）的中位生存时间最短，诊断后 5.0 个月的生存率为 29.4%。切除术对中位生存时间有显著影响，23.0 个月与未手术患者的 6.0 个月相比（log-rank p<0.001）。
阿克托贝地区的 GC 发病率不断上升，五年生存率不理想。60-69 岁的土著男性、肠型组织学类型的患者以及无论性别、种族和其他特征如何的最年轻患者，均被认为是高危人群。此外，最年轻的患者 aAPC 相对较高（5.1%），这表明他们未来可能会更加脆弱。建议进一步研究的重点是危险因素，包括基因表达谱，以找到可行的预防策略。
