Prevalence patterns of gastric cancers in Turkey: model of a developing country with high occurrence of Helicobacter pylori.
OBJECTIVE
In developed countries, there has been a recent increase in the prevalence of adenocarcinoma of the esophagus and cardia, along with a decrease in distal gastric cancers. Little is known regarding the prevalence of these diseases in developing countries. The aim of the present study was to evaluate changes in the prevalence of gastric adenocarcinomas in Turkey as a function of anatomic location.


METHODS
Data were retrospectively collected from 16 centers from January 1990 to December 2000. Owing to the exclusion criteria, a total of 4065 cases of tumors of the stomach and distal esophagus were included. Tumors localized to the body, the antrum and pyloric channel were considered distal cancers. Helicobacter pylori (H. pylori) was also detected.


RESULTS
Patients' mean age was 60.7 +/- 9 years, with a male : female ratio of 68:32. The ratio of distal/proximal adenocarcinoma was 2,1 [corrected] for the western part of Turkey and 3,8 [corrected] for the eastern part of the country (P < 0.0001), and this did not change during the 11 years. H. pylori was detected significantly less in the west compared to the east for distal tumors (65.7 vs 38.7%, respectively, P = 0.02).


CONCLUSIONS
In Turkey, a developing country with a high H. pylori prevalence, contrary to the state of developed countries, the ratio of distal versus proximal gastric adenocarcinomas has not changed. Geographical distribution should be taken into the account in projecting the changing patterns of gastric cancers.
Bor
Serhat
S
Turkish Society of Gastroenterology, Gastric Cancer Study Group, Ankara, Turkey. serhat.bor@ege.edu.tr
Vardar
Rukiye
R
Ormeci
Necati
N
Memik
Faruk
F
Suleymanlar
Inci
I
Oguz
Dilek
D
Colakoglu
Salih
S
Yucesoy
Mehmet
M
Turkdogan
Kursat
K
Gurel
Selim
S
Dogan
Ibrahim
I
Yildirim
Bulent
B
Goral
Vedat
V
Dokmeci
Gulbin
G
Okcu
Nihat
N
Duman
Deniz
D
Simsek
Ilkay
I
Demir
Ali
A
D017677:Age Distribution; D003906:Developing Countries; D005260:Female; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000382:microbiology*; D014421:Turkey / Q000453:epidemiology