Cancer Screening Center, National Cancer Center Hospital, Tokyo, Japan.
Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Digestion. 2022;103(1):22-28. doi: 10.1159/000518483. Epub 2021 Sep 7.
The global epidemiological situation of gastric cancer has changed considerably over time, and it is essential to understand the epidemiological trends and future perspectives of gastric cancer.
Although gastric cancer was common in the United States less than a century previously, it is no longer common in this country. Currently, over 60% of gastric cancers are found in Eastern Asia. In some Eastern Asian countries such as Japan and Korea, population-based gastric cancer screening has been conducted using upper gastrointestinal endoscopy or radiography to lower gastric cancer mortality. Due to earlier detection of gastric cancer, the survival of patients with gastric cancer is more favorable in these countries than in other Western countries. Even in Eastern Asia, a remarkable decrease in the age-standardized incidence and mortality of gastric cancer has been observed. This downward trend is mainly due to the reduced Helicobacter pylori infection, and this trend is considered to continue. Nevertheless, both the absolute number of incident cases and deaths of gastric cancer are still increasing at present due to the aging population. For the time being, the management of gastric cancer in elderly population is a critical issue in Eastern Asia. The absolute numbers of gastric cancer cases and deaths are believed to peak in the near future, following the decreasing age-standardized incidence and mortality. Key Messages: After a long period, gastric cancer may become a rare cancer even in Eastern Asia, and new efficient approaches for its prevention, screening, and treatment are warranted.
随着时间的推移,胃癌的全球流行病学情况发生了很大变化,了解胃癌的流行病学趋势和未来展望至关重要。
虽然在不到一个世纪以前,胃癌在美国很常见,但现在这种情况已不再常见。目前,超过 60%的胃癌发生在东亚。在日本和韩国等一些东亚国家,通过上消化道内镜或 X 线检查进行基于人群的胃癌筛查,以降低胃癌死亡率。由于胃癌的早期发现,这些国家的胃癌患者的生存率比其他西方国家更为有利。即使在东亚,胃癌的年龄标准化发病率和死亡率也显著下降。这种下降趋势主要归因于幽门螺杆菌感染的减少,而且这种趋势被认为还将继续。然而,由于人口老龄化,目前胃癌的发病例数和死亡人数仍在增加。目前,在东亚,老年人群胃癌的管理是一个关键问题。由于胃癌的发病率和死亡率呈标准化趋势,预计胃癌的发病例数和死亡人数将在不久的将来达到峰值。
经过长时间的发展,胃癌可能会在东亚成为一种罕见的癌症,因此需要寻找新的有效方法来预防、筛查和治疗胃癌。