Increased risk of gastric cancer in males affects the intestinal type of cancer and is independent of age, location of the tumour and atrophic gastritis.

Male sex, high age and atrophic gastritis (AG) are risk conditions for gastric carcinoma (GCA). We have studied the magnitude of the sex-bound risk of GCA and whether this risk is an independent risk factor for GCA or whether it is related to the risks that are mediated by age and AG. The observed frequencies of males and females in different age groups, and in presence or absence of AG, among 532 GCA patients (273 cases of intestinal (IGCA) and 259 cases of diffuse (DGCA) type) were compared with the expected frequencies which were calculated by applying the data of age-specific distributions of the sexes and AG in the general population. A significant 1.6-fold overrepresentation of males and 0.6-fold underrepresentation of females were seen in IGCA but not in DGCA. The overrepresentation of the male sex and the underrepresentation of the female sex in IGCA were independent of age of the patient and location of the tumour in the stomach. These phenomena were also independent of AG: the overrepresentation of males and the underrepresentation of females were observed in IGCA patients with normal, non-atrophic mucosa as well as in IGCA patients with AG. We conclude that the sex is an independent risk factor for IGCA, and that the phenomena which lead to overrepresentation of males and underrepresentation of females among IGCA patients (and among GCA patients in general) are unrelated to age, AG and location of the tumour in the stomach.