Gastric cancer in Iceland: a retrospective study of resected gastric specimens in a high-risk country during 30 years (1960-1989).

The world-wide incidence of gastric cancer is decreasing, especially in high-risk populations such as the Icelanders. We examined retrospectively 1,040 specimens of resected gastric cancers from a 30-year period, 1960-1989. The decrease in incidence in both sexes involved mainly the largest histological group, the intestinal-type tumours. In males there was also a decrease in diffuse tumours but in females these remained relatively unchanged. Tumours of the antrum and the corpus decreased in both sexes. In males there was a significant increase in tumours of the cardia and most of these were of the intestinal type. In females there was a minor increase in tumours of the cardia, all of which were of the intestinal type. An increase in incidence of tumours of the cardia concomitant with a decrease in incidence of tumours in other parts of the stomach suggests a difference in aetiological factors. The death risk for patients with tumours of the cardia was 59% higher than that for those with tumours in other parts. The death risk following gastric resection was not significantly different when patients with intestinal-type tumours and diffuse tumours were compared.