Worldwide inverse association between gastric cancer and esophageal adenocarcinoma suggesting a common environmental factor exerting opposing effects

Derakhshan, M. H., Arnold, M., Brewster, D. H., Going, J. J., Mitchell, D. R., Forman, D. and McColl, K. E. L. (2016) Worldwide inverse association between gastric cancer and esophageal adenocarcinoma suggesting a common environmental factor exerting opposing effects. American Journal of Gastroenterology, 111(2), pp. 228-239. (doi: 10.1038/ajg.2015.405) (PMID:26753891)

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Abstract

Objectives: The incidence of esophageal adenocarcinoma (EAC) is increasing while adenocarcinoma of the stomach is decreasing. We have investigated whether the incidences of these two cancers and their time trends might be inversely related pointing to a common environmental factor exerting opposite effects on these cancers. Methods: For cross-sectional analyses data were abstracted from “Cancer Incidence in Five Continents” (CI5) Volume X and GLOBOCAN 2012. Relevant ICD-10 codes were used to locate esophageal and gastric cancers anatomically, and ICD-O codes for the histological diagnosis of EAC. For longitudinal analyses, age standardized rates (ASRs) of EAC and total gastric cancer (TGC) were extracted from CI5C-Plus. Results: Estimated (2012) ASRs were available for 51 countries and these showed significant negative correlations between EAC and both TGC (males: correlation coefficient (CC)=−0.38, P=0.006, females: CC=−0.41, P=0.003) and non-cardia gastric cancer rates (males: CC=−0.41, P=0.003 and females: CC=−0.43, P=0.005). Annual incidence trends were analyzed for 38 populations through 1989–2007 and showed significant decreases for TGC in 89% and increases for EAC in 66% of these, with no population showing a fall in the latter. Significant negative correlation between the incidence trends of the two cancers was observed in 27 of the 38 populations over the 19–50 years of available paired data. Super-imposition of the longitudinal and cross-sectional data indicated that populations with a current high incidence of EAC and low incidence of gastric cancer had previously resembled countries with a high incidence of gastric cancer and low incidence of EAC. Conclusions: The negative association between gastric cancer and EAC in both current incidences and time trends is consistent with a common environmental factor predisposing to one and protecting from the other.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Derakhshan, Dr Mohammad and McColl, Professor Kenneth and Mitchell, David and Going, Dr James
Authors: Derakhshan, M. H., Arnold, M., Brewster, D. H., Going, J. J., Mitchell, D. R., Forman, D., and McColl, K. E. L.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:American Journal of Gastroenterology
Publisher:Nature Publishing Group
ISSN:0002-9270
ISSN (Online):1572-0241
Copyright Holders:Copyright © 2016 by the American College of Gastroenterology
First Published:First published in American Journal of Gastroenterology 111(2):228-239
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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