Disparities in Epidemiological Profile of Gastric Adenocarcinoma in Selected Cities of Brazil

Document Type: Research Articles

Authors

1 Epidemiology and Statistics Nucleus, International Research Center, A.C.Camargo Cancer Center, Sao Paulo, Brazil.

2 Anatomic Pathology Department, Rede D'Or Hospitals, Sao Paulo, Brazil.

3 Network and General Pathology, Faculty of Dentistry of the University of Sao Paulo, Brzil.

4 Department of Pathology, A.C.Camargo Cancer Center, Sao Paulo, Brazil.

5 Department of Abdominal Surgery, A.C.Camargo Cancer Center, Sao Paulo, Brazil.

6 Federal University of Pará, Brazil.

7 Hospital Haroldo Juaçaba, Cancer Institute of Ceará, Brazil.

8 Medical Genomics Laboratory, International Research Center, A.C.Camargo Cancer Center, Sao Paulo, Brazil.

Abstract

Background: Despite decreasing global incidence trends, gastric cancer is still among the five most incident cancers
in the world and the third cancer-related cause of death. In Brazil, differences in incidence and mortality exist depending
on the geographic region studied. Objective: To describe the incidence, mortality, trends and age-period-cohort of
gastric cancer in three cities of Brazil (Sao Paulo, Belem and Fortaleza), in the period 1990-2012. Mortality for gastric
cancer in Brazil overall and by region was described. Methods: 33,462 incident cases of gastric cancer were identified
from the population-based cancer registries and 23,424 deaths from mortality information system in residents of
the three cities and in Brazil were included in the study. Data for incident cases were extracted from the Population
Based Cancer Registries from the National Cancer Institute (INCA). Mortality data on gastric cancer were extracted
from Information Technology Department of Brazilian Public Health Care System/Health Ministry (DATASUS/MS).
Mortality and incidence age standardized rates were calculated. For trends analysis the Joinpoint Regression and
age-period-cohort model were applied. Results: Belem presented the highest incidence rates for gastric adenocarcinoma.
Decreasing incidence trends were identified in Sao Paulo (-7.8% in men; -6.3% in women) and in Fortaleza (-1.2%
in men). Increasing incidence trends were observed for women in Belem (1.8%) and Fortaleza (1.1%). In Belem
(Amazon area), there was an increased risk for gastric cancer in women born after the 1960s. Overall in Brazil mortality
for gastric cancer is decreasing. Mortality trends showed significant reduction, for both sexes, in the three Brazilian
cities. Conclusion: Incidence of gastric cancer is increasing in women born in the sixties in Belem (Amazon region)
and Fortaleza (Northeast region). In Brazil there was increase in mortality in Northeast region and decrease in others
regions. More update data on incidence for Amazon and Northeast region is needed.

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