Gastric cancer epidemiology and risk factors

J Clin Epidemiol. 2003 Jan;56(1):1-9. doi: 10.1016/s0895-4356(02)00534-6.


We performed a detailed analysis of the epidemiology of gastric carcinoma, based upon a review of the literature in English. The analysis reveals many puzzling features. There has been a steady fall in the incidence of gastric carcinoma in most societies studied, but a more recent steady rise in the incidence of adenocarcinoma of the cardia and lower esophagus, largely confined to White males. Although the evidence for a major role for Helicobacter pylori (H. pylori) in the etiology of gastric corpus cancer is compelling; in Western society, it probably accounts for fewer than half the cases. The relative roles of dietary constituents such as salt and nitrites and the phenotyping of H. pylori in causation and the beneficial effects of a high fruit and vegetable diet and an affluent lifestyle, for all of which there is some evidence, are yet to be quantified.

Publication types

  • Review

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Alcohol Drinking / adverse effects
  • Diet
  • Environmental Exposure / adverse effects
  • Female
  • Global Health
  • Helicobacter Infections / complications
  • Helicobacter Infections / epidemiology
  • Helicobacter pylori
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neoplasms, Radiation-Induced / etiology
  • Peptic Ulcer / complications
  • Peptic Ulcer / epidemiology
  • Risk Factors
  • Sex Distribution
  • Smoking / adverse effects
  • Stomach Neoplasms / epidemiology*
  • Stomach Neoplasms / ethnology
  • Stomach Neoplasms / pathology
  • Time Factors