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Epidemiology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Stomach cancer is the 17th most common cancer in the UK, accounting for 2% of all new cancer cases (2017).

In females in the UK, stomach cancer is the 19th most common cancer (1% of all new female cancer cases). In males in the UK, it is the 13th most common cancer (2% of all new male cancer cases).

35% of stomach cancer cases in the UK are in females, and 65% are in males.

Age and incidence

  • Stomach cancer incidence is strongly related to age, with the highest incidence rates being in older people
    • in the UK in 2015-2017, on average each year around half of new cases (51%) were in people aged 75 and over
    • age-specific incidence rates rise steadily from around age 45-49 and more steeply from around age 65-69.The highest rates are in in the 85 to 89 age group for females and males
    • incidence rates are significantly lower in females than males in a number of (mainly older) age groups.The gap is widest at age 65 to 69, when the age-specific incidence rate is 2.6 times lower in females than males.

Trends over time

  • stomach cancer European age-standardised (AS) incidence rates for females and males combined decreased by 53% in the UK between 1993-1995 and 2015-2017
    • the decrease was of a similar size in females and males
    • for females, stomach cancer AS incidence rates in the UK decreased by 53% between 1993-1995 and 2015-2017. For males, stomach cancer AS incidence rates in the UK decreased by 55% between 1993-1995 and 2015-2017
    • over the last decade in the UK (between 2005-2007 and 2015-2017), stomach cancer AS incidence rates for females and males combined decreased by 29%. In females AS incidence rates decreased by 28%, and in males rates decreased by 32%.
  • much of this decrease can be attributed to declining prevalence of Helicobacter pylori infection (a major cause of stomach cancer), and increased fresh food in the diet (and use of refrigeration rather than salting for food preservation)
    • this overall trend masks a rise in incidence of cancers in the cardia over the last 30 years in many developed countries, particularly in males, although rates have begun to decline in England since the late 1990s
    • also, improvements in housing conditions, e.g. less overcrowding, with consequently reduced transmission of Helicobacter pylori may be relevant.

Stomach cancer and deprivation:

  • stomach cancer incidence rates ( European age-standardised (AS) rates in England in females are 99% higher in the most deprived quintile compared with the least, and in males are 84% higher in the most deprived quintile compared with the least (2013-2017)
  • it is estimated that there are around 1,300 more cases of stomach cancer each year in England than there would be if every deprivation quintile had the same age-specific crude incidence rates as the least deprived quintile. Around 490 of these cases are in females, and around 830 in males.

Stage at diagnosis:

  • Stomach cancer patients with a known stage are most commonly diagnosed at stage IV (46-57%). More patients with a known stage are diagnosed at a late stage (69-75% are diagnosed at stage III or IV), than an early stage (25-31% are diagnosed at stage I or II).

Cancer incidence by ethnicity:

  • Age-standardised rates for White males with stomach cancer range from 14.1 to 14.7 per 100,000. Rates for Asian males are significantly lower, ranging from 5.2 to 8.5 per 100,000 whereas rates for Black males are significantly higher, ranging from 16.1 to 25.6 per 100,000. For females there is a similar pattern - the age-standardised rates for White females range from 5.5 to 5.8 per 100,000, while rates for Asian females are significantly lower, ranging from 2.7 to 5.0 per 100,000, and the rates for Black females are significantly higher ranging from 6.5 to 11.9 per 100,000

Stomach cancer by anatomical site:

  • the largest proportion of stomach cancer cases occur in the cardia, with much smaller proportions in the pyloric antrum and body of the stomach (2010-2012)
  • the proportion of cases in the cardia is higher in males (34.0%) than females (19.7%) and there are no marked sex differences in other parts of the stomach
  • a large proportion of cases did not have the specific part of the stomach recorded in cancer registry data, or overlapped more than one part

The incidence is higher in patients with pernicious anaemia and there is a definite link with subjects having blood group A, which suggests a genetic factor.

Occasionally, a gastric carcinoma arises in a previous gastric ulcer.

Distribution is worldwide although it is particularly frequent in some races, especially the Japanese. Any age may be involved but it especially affects the 50 to 70 age group.

Reference:


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