Gastric Cancer: an Evolving Disease.
Gastric Cancer: an Evolving Disease.
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DOI：
10.1007/s11938-018-0203-1
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发表时间：
2018-12
期刊：
影响因子：
--
通讯作者：
Camargo MC
中科院分区：
文献类型：
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作者：
Song M;Rabkin CS;Camargo MC
胃癌的主要危险因素幽门螺杆菌的患病率在全球范围内正在下降。与此趋势相对应，胃癌的发病率也在下降。历史上，受这种肿瘤影响最大的人群是男性、亚洲人和社会经济地位较低的群体。这篇综述提供了最近发表的关于胃癌流行病学变化的最新文献。胃癌发病率趋势因年龄、性别、种族/民族和肿瘤解剖位置而异。在西方人口中，幽门螺杆菌的总体发病率似乎趋于平稳，那里的幽门螺杆菌已经大幅下降。这种变化在女性和发生在食管-胃交界以外的肿瘤中更为明显。胃癌的经典发病模式正在演变。虽然不确定，但有几个假设可以解释疾病负担的变化。胃癌危险因素的混合似乎正在发生变化，幽门螺杆菌不再是唯一的病因驱动因素。这些变化可能消除了以前对男性的偏爱，并导致胃癌总体发病率的增加。针对与重大社会转型有关的已知和新因素的分析研究，可能为理解这一严重公共卫生问题的重新出现提供线索。
Prevalence of Helicobacter pylori, the primary risk factor for gastric cancer, is declining globally. Paralleling this trend, gastric cancer incidence is also decreasing. Historically, the populations most affected by this neoplasia have been males, Asians and groups with low socioeconomic status. This review provides an update on recently published literature regarding changes in gastric cancer epidemiology. Gastric cancer incidence trends vary by age, sex, race/ethnicity and tumor anatomical location. Overall incidence appears to be leveling off among young birth cohorts in Western populations, where H. pylori has declined considerably. The changes are more prominent for females and for tumors arising beyond the esophageal-gastric junction. The classical incidence pattern of gastric cancer is evolving. While uncertain, several hypotheses may explain the changing burden of disease. The mix of gastric cancer risk factors appears to be shifting, with H. pylori no longer the sole etiological driver. These changes may eliminate the previous predilection of males and lead to increases in overall gastric cancer rates. Analytical studies addressing known and novel factors related to major societal transitions may provide clues to understanding re-emergence of this serious public health problem.