title: Cancer mortality in Romania, 1955-2004. Digestive sites: esophagus, stomach, colon and rectum, pancreas, liver, gallbladder and biliary tree.
abstract: OBJECTIVE
  Until recently, gastric cancer was the most frequent digestive neoplasia in our country. Our study presents the first synthesis of data regarding mortality rates from digestive cancers, for a period covering 50 years, in Romania.
  
  
  METHODS
  Age-standardized mortality rates /100,000 population, general and/or per gender, concerning six digestive cancers, were identified from the statistics of IARC/OMS (Lyon, France) (years 1955-2002) and of the Ministry of Public Health (Bucharest, Romania) (year 2004). For 2002, incidence and mortality rates per sex from digestive cancers were available and case fatality ratios could be calculated as an approximation of survival rates, as well as sex ratio.
  
  
  RESULTS
  Age standardized mortality rates per sex and cancer site registered the following changes: esophageal cancer increased from 2.03/0.62 (M/F) to 2.8/0.5; gastric cancer registered a decrease, from 33.14/18.77 to 17.0/6.6; colorectal cancer increased from 4.65/4.57 to 13.6/9.0; pancreatic cancer increased from 5.50/2.92 to 8.1/4.2 and liver cancer (including peripheric cholangiocarcinoma) increased from 1.77/0.83 to 8.8/3.9. In our population, the case fatality ratio appeared to be better only in colorectal cancer, 0.61 in males and 0.62 in females, respectively. Sex ratio was highest for esophageal cancer (males/females 5.8/1) and lowest for colorectal cancer (1.5/1).
  
  
  CONCLUSIONS
  Our study found opposite trends in the mortality rates from digestive cancers, with gastric cancer rates decreasing and the other five digestive cancers increasing. A new hierarchy of digestive cancers has been drawn up, with colorectal cancer as the main cause of death, and gastric cancer in second position, followed by pancreatic, liver, esophageal, and gallbladder and biliary tree cancers.
authors.affiliation: Medical Clinic I, University of Medicine and Pharmacy Iuliu Hatieganu, Clinicilor str. 3-5, Cluj-Napoca, Romania. simonavalean@hotmail.com
authors.forename: Simona
authors.initials: S
authors.lastname: Vălean
authors.forename: Petru
authors.initials: P
authors.lastname: Armean
authors.forename: Simona
authors.initials: S
authors.lastname: Resteman
authors.forename: Georgiana
authors.initials: G
authors.lastname: Nagy
authors.forename: Adina
authors.initials: A
authors.lastname: Mureşan
authors.forename: Petru A
authors.initials: PA
authors.lastname: Mircea
mesh_terms: D004067:Digestive System Neoplasms / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D012383:Romania / Q000453:epidemiology; D017678:Sex Distribution