News from the Front

In selected newsletters, Dr. James Ford will provide insights into relevant research and recent headlines involving gastric cancer. Dr. Ford is a Gastric Cancer Fund board member and medical oncologist and geneticist at Stanford University Medical Center.

Gastric cancer is generally thought to be a malignancy of the elderly. However, it is certainly the impression amongst members of the Gastric Cancer Fund that an increasing number of young individuals are being diagnosed with gastric and GE junction cancers.  In support of this notion, a very provocative study was published in the Journal of the American Medical Association (JAMA) this month.  In this study, the authors used the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database, which identified over 39,000 cases of “non-cardia” gastric cancer (occurring in the lower part of the stomach) diagnosed from 1977 to 2006 (reflecting about 25% of the total US population).  They found that although stomach cancer rates continued to fall overall in the US, the incidence in 25 to 39 year old white men and women actually increased by nearly 70% over the past 3 decades.

The reasons for these disturbing observations are far from clear.  Certainly the advent of refrigeration and food preservation, and improved hygiene leading to decreased Helicobacter pylori infections, has decreased gastric cancer incidence worldwide, particularly the non-cardia cases.  Potential contributors could be dietary factors, such as salt, lifestyle issues such as obesity, changes in the virulence of strains of H. pylori, or underlying hereditary factors interacting with changing environmental stressors.  Although the absolute number of gastric cancer cases in this group of young individuals remains low, this new finding is quite noteworthy, and certainly deserves further exploration, particularly, its potential relationship to the known increase in GE junction cancers during this period.  At the Gastric Cancer Fund, we are hoping to add to our understanding of this trend by examining both environmental exposures and genetic factors leading to the development gastric cancer in further detail, through our Registry and Genomics efforts.

Age-specific trends in incidence of noncardia gastric cancer in US adults.
Anderson WF, Camargo MC, Fraumeni JF Jr, Correa P, Rosenberg PS, Rabkin CS.
JAMA. 2010 May 5;303(17):1723-8.