Epidemiological Trends and Future Perspectives of Gastric Cancer in Eastern Asia

Abstract

<b><i>Background:</i></b> The global epidemiological situation of gastric cancer has changed considerably over time, and it is essential to understand the epidemiological trends and future perspectives of gastric cancer. <b><i>Summary:</i></b> Although gastric cancer was common in the United States less than a century previously, it is no longer common in this country. Currently, over 60% of gastric cancers are found in Eastern Asia. In some Eastern Asian countries such as Japan and Korea, population-based gastric cancer screening has been conducted using upper gastrointestinal endoscopy or radiography to lower gastric cancer mortality. Due to earlier detection of gastric cancer, the survival of patients with gastric cancer is more favorable in these countries than in other Western countries. Even in Eastern Asia, a remarkable decrease in the age-standardized incidence and mortality of gastric cancer has been observed. This downward trend is mainly due to the reduced <i>Helicobacter pylori</i> infection, and this trend is considered to continue. Nevertheless, both the absolute number of incident cases and deaths of gastric cancer are still increasing at present due to the aging population. For the time being, the management of gastric cancer in elderly population is a critical issue in Eastern Asia. The absolute numbers of gastric cancer cases and deaths are believed to peak in the near future, following the decreasing age-standardized incidence and mortality. <b><i>Key Messages:</i></b> After a long period, gastric cancer may become a rare cancer even in Eastern Asia, and new efficient approaches for its prevention, screening, and treatment are warranted.

Detection and Characterization of Early Gastric Cancer

“…Although the optimal method for risk stratification of gastric cancer is still unclear, pre-endoscopic assessment of epidemiologic factors can help stratify patients at risk of gastric cancer (1). Gastric cancer is a multifactorial disease and risk factors for gastric cancer identified include older age, male gender, Helicobacter pylori (H. pylori) infection, and smoking (4)(5)(6)(9)(10)(11)(12)(13).…”

“…A family history of gastric cancer in a first-degree relative is significant as these patients have an approximately threefold greater risk of gastric cancer (9,12). Concerning the location of gastric cancer, risk factors for cancer at the cardia include obesity and gastroesophageal reflux disease (5,6,9). For non-cardia gastric cancer, H. pylori infection and smoking have been identified as risk factors (5,9).…”

“…Gastric cancer is the fifth most frequently diagnosed cancer and the third most common cause of death due to cancer, with the highest incidence being reported in Korea, Japan, and Mongolia (5). Population-based gastric cancer screening endoscopy programs in Japan for adults aged >50 years and in Korea for adults aged >40 years have resulted in the early detection of gastric cancer with a resultant significant decrease in mortality (5,6). Image enhanced endoscopic technology (IEE), also called advanced endoscopic imaging, which includes Narrow Band Imaging (NBI), Flexible Spectral Imaging Color Enhancement (FICE), blue laser imaging (BLI), probe based Confocal Laser Endomicroscopy (pCLE), improves detection of gastric intestinal metaplasia, dysplasia, and early gastric cancer (2,7,8).…”

Quantitative Dynamic-Enhanced MRI and Intravoxel Incoherent Motion Diffusion−Weighted Imaging for Prediction of the Pathological Response to Neoadjuvant Chemotherapy and the Prognosis in Locally Advanced Gastric Cancer

“…Gastric cancer (GC) represents the fifth most frequent cancer worldwide with 1,089,103 new cases (5.6%) and the fourth leading cause of cancer-related death (7.7%) with 768,793 deaths each year in 2020, according to global cancer statistics ( 1 ). In particular, gastric cancer has a high incidence in East Asia, which accounts for about 60% newly diagnosed cases worldwide ( 1 , 2 ).…”

The Molecular Roles and Clinical Implications of Non-Coding RNAs in Gastric Cancer

“…The uniform declines in incidence have been observed in many parts of the world for decades, including China ( Luo et al, 2017 ). Early detection of gastric cancer is considered to have contributed to favorable survival ( Sekiguchi et al, 2021 ). In 2004, an early detection and treatment program was initiated in China with special funds from the Ministry of Health ( Zheng et al, 2015 ).…”