Gastric Cancer in Northern Canadian Populations: A Focus on Cardia and Non-Cardia Subsites

Abstract

In northern Canada where there is a high prevalence of Helicobacter pylori infection, there is a paucity of information on gastric cancer by the topographical subsites cardia (CGC) and non-cardia (NCGC). Here we describe the incidence of CGC and NCGC, separately, among northern Canadian populations. We used data from the Cancer Incidence in Five Continents Volumes X (CI5X) and XI (CI5XI) to obtain CGC and NCGC incidence for Canada and for Yukon (YT), a northern Canadian territory. Using these data with those provided by the Government of the Northwest Territories (NT), we estimated standardized incidence ratios comparing northern populations to Canada as a whole. We also estimated age-standardized incidence rates to permit comparisons across populations globally. NT and YT populations were disproportionately impacted by gastric cancer, particularly NCGC. This was especially true for Indigenous populations: NCGC incidence rates among NT Indigenous men were 2.7 times the rates among all men in Canada, while rates among NT Indigenous women were 3.1 times the rates among all women in Canada. Similarly, age-standardized rates of NCGC among Indigenous NT residents were comparable to global regions where there is a high burden of NCGC. This study has, for the first time, quantified the incidence of CGC and NCGC for the NT and YT, providing new insights into the burden of these cancers among northern Canadian populations.

Geographic and Socioeconomic Disparity of Gastric Cancer Patients in Canada

“…Among the 11 highest incidence FSA found in our study, 4 (36%) were home to First Nation communities. These included the Miawpukek (A0H), We'koqma'q (B0E), Gaspé (G0E), and Essipit (G0T) communities [48][49][50] supporting recent literature showing 3-fold increase in gastric cancer incidence in Northern Canadian population [51]. In 2010, it was estimated that 28% of Inuit and 27% of First Nation community members experienced moderate to severe household food insecurity vs. 8% of average Canadians [52].…”

“…The highest incidence rates in our country corresponded to rural/remote communities where high rates of food insecurity, obesity, and/or other risk factors (e.g., visible minority, low SES) are well characterized. High incidence rates in First Nation communities were confirmed [51]. Identified high-risk communities should not be ignored as it is estimated that up to 30% of gastric cancer cases may be preventable through risk factor modification [75,76].…”

Combating Gastric Cancer in Alaska Native People: An Expert and Community Symposium

“…2,3,7 The pattern of gastric cancer in Indigenous Canadians and the Maori of New Zealand is similar to that in the AN population, with cancer occurring at higher rates in younger people and in women compared with their majority populations and with a higher proportion that are diffuse and noncardia in location. 8,9 Esophagogastroduodenoscopy (EGD) performed in Canadian Arctic communities found a high prevalence of severe gastritis and atrophy, 10 although treatment of H pylori was generally successful, and antimicrobial resistance was lower than that seen in Alaska.…”

“…We would like to thank Judith Muller, Jennifer Williamson, Rachel Schaefer, Karli Tyance-Hassel, Jennie Lee, Theresa Wells, Rosalyn Marcellais, and Garret Spargo for their assistance in organizing and facilitating this symposium and Sophie Nothstine for providing the traditional prayer to start our meeting. We would like to thank all participants for their input during this symposium: Joe 3 Frank Sacco, 3 Sarah Nash, 3 Matthew J. Olnes, 3 Karen Miernyk, 1 Dana Bruden, 1 Maya Ramaswamy, 1 Brian McMahon, 1,3 Karen J. Goodman, 4 Adam J. Bass, 5 Chin Hur, 6 Manami Inoue, 7 M. Constanza Camargo, 8 Soo-Jeong Cho, 9 Kalani Parnell, 3 Elizabeth Allen, 10 Tina Woods, 3 and Stephanie Melkonian. 11 1 Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; 2 University of Alaska Anchorage, Anchorage, Alaska; 3 Alaska Native Tribal Health Consortium, Anchorage, Alaska; 4 University of Alberta, Edmonton, Alberta, Canada; 5 Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; 6 Columbia University, New York, New York; 7 Center for Public Health Sciences, National Cancer Center, Tokyo, Japan; 8 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland; 9 Seoul National University Hospital, Seoul, Korea; 10 This Symposium leader discloses the following: Adam J. Bass receives funding from Bayer, Merck, and Novartis and is a cofounder of Signet Therapeutics.…”

Geographical variation and factors associated with gastric cancer in Manitoba

“…Therefore, only one third of all diagnosed GC cases live beyond five years, which is one of the lowest cancer survival rates [3]. In some parts of the world, researchers have studied the geographical and temporal variation of GC with the sole purpose of understanding its propagation [4][5][6][7]. However, there is very limited information about the geographical variation in Canada.…”