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Trends in gastric and esophageal cancer incidence in northern Portugal (1994-2009) by subsite and histology, and predictions for 2015

Abstract

Introduction

Gastric cancer (GC) and esophageal cancer (EC) share risk factors, and the incidence trends reflect differences in etiology according to their subtypes. We aimed to describe the incidence trends of GC (by topography) and EC (by histological type) in northern Portugal for 1994-2009 and to estimate the incidence for 2015. We further analyzed exposure to the main risk factors for these cancers in the region over the last decades.

Methods

GC and EC data were obtained from the North Region Cancer Registry of Portugal (RORENO). Joinpoint regression was used to compute annual percent changes (APC) in incidence trends. Poisson regression yielded estimates for 2015. A literature review up to 2014 provided data on exposure to risk factors.

Results

GC rates decreased in 1994-2009 (men, APC = -1.3; women, APC = -1.6); GC, unspecified subtype, had the steepest decline since the early 2000s (men, APC = -4.9; women, APC = -6.3). The incidence for 2015 will increase for EC in men (up to ≈190 cases) and stabilize in women (≈30) and for GC (≈730 men, ≈500 women). Increasing prevalence of tobacco smoking among women and overweight/obesity, fairly stable prevalence of alcohol, fruit and vegetable consumption, and no trend for Helicobacter pylori infection were observed.

Conclusions

The declining incidence of GC unspecified subtype indicated an improvement in cancer registration accuracy, but precluded a sound assessment of trends by subtype. Variations in the prevalence of exposure to some risk factors were consistent with observed incidence trends, and future studies should aim to quantify their contribution to the GC and EC burden in the region.

Tumori 2017; 103(2): 155 - 163

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000542

Authors

Clara Castro, Bárbara Peleteiro, Maria José Bento, Nuno Lunet

Article History

Disclosures

Financial support: This work was supported by “Fundo Europeu de Desenvolvimento Regional” (FEDER) funds through the “Programa Operacional Factores de Competitividade” (POFC) – COMPETE (grant number FCOMP-01-0124-FEDER-021181), by national funds through the “Fundação para a Ciência e a Tecnologia” (PTDC/SAU-EPI/122460/2010 and SFRH/BPD/75918/2011) and by the Epidemiology Research Unit of the Institute of Public Health, University of Porto (UID/DTP/047507/2013).
Conflict of interest: The authors declare no conflict of interest.

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Authors

Affiliations

  • North Region Cancer Registry (RORENO) – Portuguese Oncology Institute, Porto - Portugal
  • EPIUnit – Institute of Public Health, University of Porto, Porto - Portugal
  • Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto - Portugal

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