title: The decreasing burden of gastric cancer in Japan.
abstract: Gastric cancer in Japan, previously the top killer cancer, has recently shown decreased incidence and mortality rates. Epidemiological studies have demonstrated that environmental factors are closely associated with stomach oncogenesis, as evident from the geographical differences seen throughout Japan in both incidence and mortality. Moreover, Japanese immigrant populations gradually exhibit the lower incidence and mortality rates of gastric cancer in their chosen country. Likewise, younger generations in Japan have lower mortality rates than older generations at the same age, which may be accounted by the dramatic lifestyle changes in Japan after World War II. In addition to exploring and learning from the impact of these environmental factors, deliberate strategies to further lower the incidence and mortality rates of gastric cancer must include aggressive eradication programs for Helicobacter pylori and dietary education in both school curricula and for the general adult population to lower the intake of causative agents such as salt and increase the intake of beneficial agents such as fruits, vegetables and seaweeds. The dietary education should be coupled with better motivation for the general population to undergo regular screening with improved techniques. In the future, changes in these environmental factors and progresses in the diagnosis of and therapeutic strategies for gastric cancer will lead to further decrease in the incidence and mortality rates of this disease in Japan.
authors.affiliation: Department of Social Medicine, Hirosaki University School of Medicine, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Matsuzaka
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Fukuda
authors.forename: Ippei
authors.initials: I
authors.lastname: Takahashi
authors.forename: Sen
authors.initials: S
authors.lastname: Shimaya
authors.forename: Takao
authors.initials: T
authors.lastname: Oyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Yaegaki
authors.forename: Tadashi
authors.initials: T
authors.lastname: Shimoyama
authors.forename: Juichi
authors.initials: J
authors.lastname: Sakamoto
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Nakaji
authors.forename: Takashi
authors.initials: T
authors.lastname: Umeda
mesh_terms: D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D013274:Stomach Neoplasms / Q000453:epidemiology*