title: Time trends of mortality from gastric cancer in Europe.
abstract: BACKGROUND
  The time trends of gastric and duodenal ulcer disease are shaped by a birth-cohort phenomenon.
  
  
  OBJECTIVE
  The aim of this study was to assess the extent by which a birth-cohort phenomenon also affected the long-term time trends of gastric cancer among different European countries.
  
  
  METHODS
  Mortality data from France, Germany, Netherlands, Scotland, Spain, and Sweden of the past 56-85 years were analyzed. The age-specific death rates were plotted against the period of death as period-age contours and against the period of birth as cohort-age contours.
  
  
  RESULTS
  The long-term time trends of gastric cancer mortality were found to have risen among generations born during the 18th century until the mid-19th century and then to have declined in all subsequent generations. The rise and fall of gastric cancer preceded similar birth-cohort patterns of gastric and duodenal ulcer by about 10-30 years. With the exception of gastric cancer in Germany, similar birth-cohort phenomena were found in all countries, as well as in men and women.
  
  
  CONCLUSIONS
  The time trends of mortality from gastric cancer and peptic are shaped by birth-cohort patterns that have affected all countries of Europe. It remains an enigma why mortality associated with gastric cancer and peptic ulcer suddenly started to rise within a short time period during the 19th century.
authors.affiliation: The Oregon Health and Science University, and Portland VA Medical Center, Portland, OR 97239, USA. sonnenbe@ohsu.edu
authors.forename: Amnon
authors.initials: A
authors.lastname: Sonnenberg
mesh_terms: D000230:Adenocarcinoma / Q000266:history / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004381:Duodenal Ulcer / Q000266:history / Q000401:mortality; D005060:Europe / Q000453:epidemiology; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000266:history / Q000401:mortality*; D013276:Stomach Ulcer / Q000266:history / Q000401:mortality; D055815:Young Adult