Changing trends in gastrointestinal disease in the Asia–Pacific region

Abstract

The new millennium has seen distinct changes in the pattern of gastrointestinal disease in the Asia–Pacific region. These changes are important as more than half of the world's population come from the region and therefore impact significantly on the global disease burden. The highest incidence of gastric cancer (GCA) has been reported from Asia and GCA remains a very important cancer. However time‐trend studies have shown a decrease in GCA incidence in several countries in Asia. A rise in cardio‐esophageal cancers as seen in the West has not been reported. On the other hand, colorectal cancer has been steadily increasing in Asia with age‐standardized incidence rates of some countries approaching that of the West. The pattern of acid‐related diseases has also changed. Gastroesophageal reflux disease is a fast emerging disease with an increasing prevalence of reflux esophagitis and reflux symptoms. The prevalence of peptic ulcer disease has at the same time declined in step with a decrease in H. pylori infection. Many of the changes taking place mirror the Western experience of several decades ago. Astute observation of the epidemiology of emerging diseases combined with good scientific work will allow a clearer understanding of the key processes underlying these changes. With rapid modernization, lifestyle changes have been blamed for an increase in several diseases including gastroesophageal reflux disease, nonalcoholic fatty liver disease and colorectal cancer. A worrying trend has been the increase in obesity among Asians, which has been associated with an increase in metabolic diseases and various gastrointestinal cancers. Conversely, an improvement in living conditions has been closely linked to the decrease in GCA and H. pylori prevalence.

Changes of Upper Gastrointestinal Symptoms and Endoscopic Findings in Japan Over 25 Years

“…There have been considerable changes in the epidemiology of upper gastrointestinal (GI) disease in the Asia-Pacific region over the past decade (1). A decline in the prevalence of peptic ulcer disease in the West over the past three to four decades has been reported (2).…”

Clinical Validation of Colorectal Cancer Biomarkers Identified from Bioinformatics Analysis of Public Expression Data

“…In the United States, it is the second and third highest ranked cancer in mortality and incidence, respectively (1). The incidence of colorectal cancer is also rising rapidly in other parts of the world including several Asian countries for which westernized dietary lifestyle has been implicated as the major cause (2,3). Five-year survival is dramatically improved if diagnosis is made at early stages, but limited access to effective colonoscopic screening remains a problem (1).…”

Lack of association between TYK2 and STAT3 genes and Crohn’s disease in the Malaysian population

“…CD is characterized by transmural inflammatory lesions that affect virtually any part of the gastrointestinal tract (Raelson et al, 2007). In the past few decades, CD was thought to be a "western" disease, with higher prevalence rates reported in developed countries, relative to those of Asia (Yang et al, 2001;Goh, 2007). However, recent epidemiological studies have revealed an increasing trend in CD incidence and prevalence rates in this geographical region (Yang et al, 2001;Leong et al, 2004;Ouyang et al, 2005).…”