stric cancer, or cancer of the stomach, was once considered a single entity. Now, epidemiologists divide this cancer into two main classes: gastric cardia cancer (which is cancer of the top inch of the stomach, where it meets the esophagus) and non-cardia gastric cancer (cancer in all other areas of the stomach). This classification was adopted because these two types of stomach cancer have different risk factors and different patterns of occurrence. For example, H. pylori has been established as a strong risk factor for non-cardia gastric cancer, whereas its association with gastric cardia cancer is controversial.
In 2006, there will be an estimated 22,280 new cases of gastric cancer and approximately 11,430 deaths due to the disease in the U.S. Gastric cancer is the second most common cause of cancer-related deaths in the world, killing approximately 700,000 people in 2002. Gastric cancer is more common in developing countries than in the U.S.
Overall gastric cancer incidence rates are decreasing. However, this decline is mainly in non-cardia gastric cancer rates. In contrast, gastric cardia cancer rates are increasing, particularly in Western countries, such as the U.S. and many parts of Europe. Gastric cardia cancer, which was once very uncommon, now constitutes nearly half of all stomach cancers in white males in the U.S.
Infection with H. pylori is the most important risk factor for gastric cancer. Other risk factors include chronic gastritis (inflammation of the stomach); older age; being male; a diet high in salted, smoked, or poorly preserved foods and low in fruits and vegetables; certain types of anemia; smoking cigarettes; and a family history of stomach cancers.
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