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News

Noncardia gastric cancer remains deadly in the US

November's issue of the American Journal of Gastroenterology reports no significant improvement in noncardia gastric cancer survival over the past 20 years.

News image

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Noncardia gastric adenocarcinoma is not frequently mentioned in the United States.

However, it is unclear if the previously reported decline in noncardia gastric adenocarcinoma has continued.

It is also unclear if detection and management has affected overall survival outside the setting of clinical trials.

Dr Hashem El-Serag and colleagues from Texas identified all cases of noncardia gastric adenocarcinoma diagnosed between 1973 and 2002.

The research team accessed the used the Surveillance, Epidemiology, and End Results registry.

Incidence rates were 2- to 3-fold higher in Blacks and Asians
American Journal of Gastroenterology

The team then calculated the yearly age-adjusted incidence rates and the relative survival rates.

Cox proportional hazards models were used to examine temporal trends from 1983 to 2003.

Between 1973 and 2002, there were 24,103 cases of noncardia gastric adenocarcinoma.

The team found that the age-adjusted yearly incidence rate declined by 23% between 1973 and 2002 from 4 to 3 per 100,000 person-years.

However, the incidence of localized noncardia gastric adenocarcinoma remained without change at about 1 per 100,000 person-years.

The researchers noted that the incidence of localized noncardia gastric adenocarcinoma increased with age, especially in the over 85 year age group.

The team observed that the incidence rates in men were double those in women.

The incidence rates were 2-fold and 3-fold higher in Blacks and Asians, respectively, compared with whites.

Patients with radiation and chemotherapy after gastrectomy had a 22% better mortality risk compared with those treated with gastrectomy alone.

The researchers showed no significant change in mortality risk related to year of diagnosis between 1983 and 2002.

However, the team found significant independent regional and racial variations in survival.

Asians had a 17% lower mortality risk compared with whites.

Dr El-Serag's team concludes, “Despite the overall decline in noncardia gastric adenocarcinoma, the incidence of local stage disease has remained stable in most ages and even increased in old ages.”

“Unfortunately, there has been no significant improvement in survival during the past 20 years.”

“Moreover, there remain considerable regional as well as racial variations in mortality.”

Am J Gastroenterol 2006: 101(11): 2485
07 November 2006

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