Epidemiologic trends in esophageal and gastric cancer in the United States.
Use of tobacco, moderate to heavy alcohol ingestion, infrequent consumption of raw fruits and vegetables, and low income accounted for more [figure: see text] than 98% of the SCE rates among both African American and white men and for 99% of the excess incidence among African Americans compared to whites in a case-control study in three areas of the United States [14]. Thus, it is likely that declines in the prevalence of smoking and drinking, especially among men, and increased intake of fresh fruits and vegetables may have contributed to the downward incidence and mortality rate trends reported for SCE. In addition, it seems plausible that obesity, GERD, and possibly reductions in H. pylori prevalence have contributed to the upward trends in ACE rates. Reductions in smoking, improved diet, and reductions in H. pylori prevalence probably have contributed to the consistent reductions observed for NGA. Contributing factors are less clear for the rising incidence rates of GCA during the 1970s and 1980s. These incidence rates have not continued to rise in recent years.
Brown
Linda Morris
LM
Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Room 8026, MSC 7244, Bethesda, MD 20892-7244, USA. brownl@mail.nih.gov
Devesa
Susan S
SS
D000230:Adenocarcinoma / Q000453:epidemiology*; D001741:Black or African American; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D004032:Diet; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D018426:SEER Program; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000401:mortality; D014481:United States / Q000453:epidemiology; D044465:White People