Gastric and colorectal cancer in patients attending mission hospitals in rural areas of South-east Asia.
25 missionaries working in Taiwan, Thailand, Indonesia and the Philippines completed questionnaires regarding their clinical practice during the year 1980. Data were collected on the numbers of both gastric and colorectal cancers diagnosed. More than 90,000 out-patients were reviewed, and over 25,000 in-patients treated. In total, 76 gastric and 118 colorectal carcinomas were seen. Surgery and radiology were available at 88% of hospitals, but histology at only 53%. In both Indonesia and the Philippines, the relative risk of developing colorectal compared with gastric cancer was 3.3 (95% confidence limits 1.8-6.2 and 1.4-8.5, respectively). In Thailand and Taiwan, these tumours occurred with similar frequencies. Thailand, Indonesia and the Philippines had similar numbers of gastric neoplasms, but Taiwan a significantly higher number than the other countries (z > or = 4.4, p < 0.0001). Thailand had lower numbers of colorectal tumours than the Philippines, (z = 2.2, p < 0.05), Taiwan (z = 3.4, p < 0.001) and Indonesia (p = 5.0, p < 0.0001). Local dietary factors probably play an important role in the development of these tumours.
Hart
A R
AR
Leicester General Hospital, UK.
Mann
R
R
Mayberry
J F
JF
D002835:Christianity; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D003906:Developing Countries; D016519:Hospitals, Religious; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D066189:Missionaries; D010679:Philippines / Q000453:epidemiology; D008921:Religious Missions; D012307:Risk Factors; D012424:Rural Population; D013274:Stomach Neoplasms / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology