The prognostic effect of ethnicity for gastric and esophageal cancer: the population-based experience in British Columbia, Canada

Abstract

BackgroundGastric and esophageal cancers are among the most lethal human malignancies. Their epidemiology is geographically diverse. This study compares the survival of gastric and esophageal cancer patients among several ethnic groups including Chinese, South Asians, Iranians and Others in British Columbia (BC), Canada.MethodsData were obtained from the population-based BC Cancer Registry for patients diagnosed with invasive esophageal and gastric cancer between 1984 and 2006. The ethnicity of patients was estimated according to their names and categorized as Chinese, South Asian, Iranian or Other. Cox proportional hazards regression analysis was used to estimate the effect of ethnicity adjusted for patient sex and age, disease histology, tumor location, disease stage and treatment.ResultsThe survival of gastric cancer patients was significantly different among ethnic groups. Chinese patients showed better survival compared to others in univariate and multivariate analysis. The survival of esophageal cancer patients was significantly different among ethnic groups when the data was analyzed by a univariate test (p = 0.029), but not in the Cox multivariate model adjusted for other patient and prognostic factors.ConclusionsEthnicity may represent underlying genetic factors. Such factors could influence host-tumor interactions by altering the tumor's etiology and therefore its chance of spreading. Alternatively, genetic factors may determine response to treatments. Finally, ethnicity may represent non-genetic factors that affect survival. Differences in survival by ethnicity support the importance of ethnicity as a prognostic factor, and may provide clues for the future identification of genetic or lifestyle factors that underlie these observations.

Stomach cancer mortality among agricultural workers: results from a death certificate-based case-control study

“…According to a study conducted in USA 34 , rates of gastric cardia cancer were higher among non-Hispanic white men. In addition, survival of gastric cancer was also poorer among non-Hispanic whites than among individuals from any other ethnic group, according to another study conducted in USA 35 . Moreover, agricultural workers aged 20-49 years had a 2.15 greater risk of dying from stomach cancer compared with non-agricultural workers in the same age group.…”

Survival Rate and Prognostic Factors of Esophageal Cancer in East Azerbaijan Province, North-west of Iran

“…Esophageal cancer is the eighth most common cancer and the sixth leading cause of cancer mortality in the worldwide (Bashash et al, 2011). The north of Iran (lies in the central Asian belt) have been observed to dominate malignancies of esophageal cancer.…”

Mortalidade por câncer de estômago em Volta Redonda-RJ, 1981-2008

“…20 Apesar de apresentar tendência decrescente de mortalidade, a neoplasia maligna de estômago todavia requer bastante atenção, visto que ainda figura como a segunda principal causa de morte por câncer no mundo. 1 Em Volta Redonda-RJ, essa doença representou a segunda causa de morte por câncer entre homens e a quarta entre as mulheres, no ano de 2011. 4 As políticas de prevenção e tratamento do câncer de estômago devem ser reforçadas e direcionadas, principalmente, a indivíduos do sexo masculino.…”

“…Apesar disso, observou-se uma redução em sua incidência, atribuída a uma menor exposição aos fatores de risco. 1,2 A Helicobacter pylori (H. pylori), bactéria carcinogênica, é considerada o agente causal mais importante na etiologia do câncer de estômago. Entre outras prováveis causas desse tipo de câncer, destacam-se dietas ricas em sal, nitrito, nitrato e carboidrato, e pobres em vitaminas A, C e E, bem como alta ingestão de bebida alcoólica e uso de tabaco.…”

“…2 A neoplasia de estômago apresenta uma taxa de sobrevida de cinco anos para -somente -menos de 20% dos casos. 1 A prevenção, por meio de hábitos alimentares saudá-veis e da redução da infecção pela H. pylori, assim como a detecção precoce, são medidas que podem auxiliar na redução da morbimortalidade por neoplasia gástrica. 2 O presente trabalho justifica-se pela elevada incidência de câncer gástrico entre homens e mulheres no Brasil e no mundo, e pela alta letalidade desse tipo de câncer.…”