Rising trends of gastric cancer and peptic ulcer in the 19th century.
BACKGROUND
The risk of dying from gastric cancer appears to have increased among consecutive generations born during the 19th century.


OBJECTIVE
To follow the time trends of hospitalization for gastric cancer and test whether they confirm such increase.


METHODS
Inpatient records of the last two centuries from four hospitals in Scotland and three US hospitals were analysed. Proportional rates of hospitalization for gastric cancer, gastric ulcer and duodenal ulcer were calculated during consecutive 5-year periods.


RESULTS
The data from all seven cities revealed strikingly similar patterns. No hospital admissions for gastric cancer or peptic ulcer were recorded prior to 1800. Hospital admissions for gastric cancer increased in an exponential fashion throughout the 19th and the beginning of the 20th century. In a majority of cities, the rise in hospitalization for gastric cancer preceded a similar rise in hospitalization for gastric ulcer. Hospitalization for these two latter diagnoses clearly preceded hospitalization for duodenal ulcer by 20-40 years.


CONCLUSIONS
The occurrence of gastric cancer, gastric ulcer and duodenal ulcer markedly increased during the 19th century. Improvements in hygiene may have resulted in the decline of infections by other gastrointestinal organisms that had previously kept concomitant infection by Helicobacter pylori suppressed.
Sonnenberg
A
A
Department of Veteran Affairs Medical Center and Oregon Health & Science University, Portland, OR, USA. sonnenbe@ohsu.edu
Baron
J H
JH
D001900:Boston / Q000453:epidemiology; D049672:History, 19th Century; D049673:History, 20th Century; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D009518:New York / Q000453:epidemiology; D010437:Peptic Ulcer / Q000453:epidemiology / Q000266:history*; D015143:Philadelphia / Q000453:epidemiology; D012111:Residence Characteristics; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000266:history*