Trends in incidence rates of oesophagus and gastric cancer in Italy by subsite and histology, 1986-1997.
OBJECTIVE
Population-based studies in Western countries suggest that the incidence of oesophageal adenocarcinoma (OA) and gastric cardia adenocarcinoma (GCA) is increasing, whereas the incidence of distal gastric carcinoma and oesophageal squamous cell carcinoma (OSCC) is declining. This is the first population-based study carried out in a southern European region to evaluate the time trends in incidence rates of oesophageal and gastric tumours according to subsite and histology over the period 1986-1997.


METHODS
Cancer cases were drawn from seven registries of the Italian Network of Cancer Registries, which covers approximately 9% of the Italian population (annual average 5 027 944). Time trends in age and sex-standardized incidence rates were reported. Estimated annual percentage changes (EAPC) and related 95% confidence intervals (CI) were estimated by modelling age, sex, subsite and morphology-specific incidence rates through Poisson log-linear regression, and whenever necessary negative-binomial regression. Overall, 25 895 gastric and 2497 oesophageal carcinomas were examined.


RESULTS
On the whole, an increasing trend was observed for OA plus GCA. The increase was statistically significant in younger women (<60 years: EAPC 3.7; 95% CI 0.2; 7.3) and in older men (>75 years: EAPC 4.0; 95% CI 1.2; 6.9). Similar trends were also observed in proximal gastric cancer (GCA plus fundus). A decline in the stomach subfundus incidence was observed in both sexes and in each age group. OSCC decreased significantly in men (EAPC-2.6; 95% CI-4.1;-0.9).


CONCLUSIONS
It is plausible that the different tendencies in oesophageal and proximal gastric cancer in men and women are attributable to heterogeneous distributions of risk factors by sex or age.
Orengo
Maria A
MA
Liguria Cancer Registry (CR), Descriptive Epidemiology, National Cancer Research Institute (IST), Genoa, Italy.
Casella
Claudia
C
Fontana
Vincenzo
V
Filiberti
Rosangela
R
Conio
Massimo
M
Rosso
Stefano
S
Tumino
Rosario
R
Crosignani
Paolo
P
De Lisi
Vincenzo
V
Falcini
Fabio
F
Vercelli
Marina
M
D000230:Adenocarcinoma / Q000453:epidemiology* / Q000473:pathology; D017677:Age Distribution; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012042:Registries; D017678:Sex Distribution; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000473:pathology