Abstract Epidemiology of gastric carcinoma. Abstract for presentation at Porto meeting – 27th April 2006-04-03 David Forman Professor of Cancer Epidemiology University of Leeds, Leeds, UK
Worldwide, there are currently over 900000 new diagnoses of gastric cancer each year
making this the 3rd and 5th most common form of cancer in males and females
respectively. There is a ten-fold variation in incidence between the highest and lowest
risk populations and rates are notably high in East Asia, South America and Eastern
Europe. Incidence rates in most populations have been declining substantially over
several decades. Gastric cancer arising in the proximal cardia region of the stomach has
been reported, however, to show different trends from that of the disease in the distal
stomach. This form of the cancer maybe increasing in incidence in some populations
and it also has a different geographical distribution and a higher male to female
incidence ratio compared with distal cancer. Classification problems and variation in
recording practice complicate accurate reporting of cardia cancer. The main identified
environmental risk factors for gastric cancer are various dietary exposures and
Helicobacter pylori infection. Of the former, much evidence relates increased
consumption of fruit and vegetables to a decreased risk of gastric cancer although more
recent prospective studies are failing to confirm this relationship. There is no evidence
that vitamin supplementation reduces the risk of gastric cancer. Although much research
has been carried out into the role of dietary salt and nitrate intake and alcohol
consumption in the aetiology of gastric cancer there is no clear consensus about the
importance of these risk factors. H. pylori infection has been associated with at least a
six-fold risk of cancer although there is now evidence that the risk is substantially
higher. It is, therefore, becoming necessary to interpret the role of other risk factors,
alongside that of H. pylori, and to investigate whether they help determine which H. pylori infected subjects proceed along the carcinogenic pathway.
Curriculum Vitae David Forman- biography David Forman studied biology for his first degree at Keele University and subsequently undertook a PhD at Southampton University. He had postdoctoral appointments at the University of Glasgow and with the Imperial Cancer Research Fund (ICRF) in Mill Hill. While there, he developed an interest in cancer epidemiology and in 1982 moved to the ICRF Epidemiology Unit in Oxford, under the directorship of the late Sir Richard Doll. He remained in Oxford for 12 years becoming a Principal Research Scientist with ICRF and a Research Fellow at Green College. In 1994 Professor Forman took up his present post as Professor of Cancer Epidemiology at the University of Leeds. He is also Director at the Northern and Yorkshire Cancer Registry and currently chairs the UK Association of Cancer Registries. Professor Forman’s main research interests have been concerned with the aetiology of gastro-intestinal cancers, especially stomach cancer, and with trends in the incidence and management of cancers. During the last decade, he has been involved in developing the discipline of cancer care epidemiology: population-based research into the delivery of effective cancer care. He is the author of over 150 research papers and is also Co-
ordinating Editor for the Cochrane Collaboration Group in Upper Gastro-intestinal and Pancreatic Diseases. In 2001, he was elected as one of the first non-clinical Fellows of the U.K. Faculty of Public Health Medicine. Selected recent publications: Wu AH, Crabtree JE, Bernstein L, Hawtin P, Cockburn M, Tseng CC, Forman D. (2003) Role of Helicobacter pylori CagA+ strains and risk of adenocarcinoma of the stomach and esophagus. International Journal of Cancer103:815-21. Barrett JH, Smith G, Waxman R, Gooderham N, Lightfoot T, Garner RC, Augustsson K, Wolf CR, Bishop DT, Forman D and the Colorectal Cancer Study Group. (2003) Investigation of interaction between N-acetyltransferase 2 and heterocyclic amines as potential risk factors for colorectal cancer. Carcinogenesis 24:275-82 Moayyedi P, Soo S, Deeks J, FormanD, Harris A, Innes M, Delaney B. (2003) Systematic review: Antacids, H2-receptor antagonists, prokinetics, bismuth and sucralfate therapy for non-ulcer dyspepsia. Alimentary Pharmacology and Therapeutics 17:1215-27. Forman D, Stockton D, Møller H, Quinn M, Babb P, De Angelis R, Micheli A. (2003) Cancer prevalence in the United Kingdom: results from the EUROPREVAL Study. Annals of Oncology 14:648-54.
Verdecchia A, Corazziari I, Gatta G, Lisi D, Faivre J, FormanD. (2004) Explaining gastric cancer survival differences among European countries. International Journal of Cancer109: 737-41. Turner F, Smith G, Sachse C, Lightfoot T, Garner RC, Wolf CR, Forman D, Bishop DT, Barrett JH (on behalf of the Colorectal Cancer Study Group). (2004) Vegetable, fruit and meat consumption and potential risk modifying genes in relation to colorectal cancer. International Journal of Cancer112:259-264. Ford A, Delaney BC, Forman D, Moayyedi P. (2004) Eradication therapy in Helicobacter pylori positive peptic ulcer disease: Systematic review and economic analysis. American Journal of Gastroenterology 99: 1833-55. Rapley EA, Hockley S, Warren W, Johnson L, Huddart R, Crockford G, Forman D et al (2004) Somatic mutations of KIT in familial testicular germ cell tumours. British of Journal of Cancer.90:2397-401.
Ford A, Forman D, Reynolds PD, Cooper BT, Moayyedi P. (2005) Ethnicity, gender, and socioeconomic status as risk factors for esophagitis and Barrett's esophagus. American Journal of Epidemiology 162:454-60. McGreavey LE, Turner F, Smith G, Boylan K, Bishop DT, Forman D, Wolf CR, Barrett JH and the Colorectal Cancer Study Group. (2005) No Evidence that polymorphisms in CYP2C8, CYP2C9, UGT1A6, PPARd and PPARg act as
modifiers of the protective effect of regular NSAID use on the risk of colorectal carcinoma. Pharmocogenetics and Genomics 15:713-721. Moayyedi P, Forman D, Duffett S, Mason S, Brown J, Crocombe W, Feltbower R, Axon A on behalf of the Leeds HELP study group. (2005) The association between Helicobacter pylori infection and adult height. European Journal of Epidemiology 20:455-65. Cook MB, Wild CP, Forman D (2005) A systematic review and meta-analysis of the sex ratio for Barrett's esophagus, erosive reflux disease, and nonerosive reflux disease. American Journal of Epidemiology.162:1050-61. Ford AC, Forman D, Bailey AG, Axon AT, Moayyedi P (2005) A community screening program for Helicobacter pylori saves money: 10-Year follow-up of a randomized controlled trial. Gastroenterology.129:1910-17. Du Y, Agnew A, Ye XP, Robinson PA, Forman D, Crabtree JE (2006)Helicobacter pylori and Schistosoma japonicum co-infection in a Chinese population: helminth infection alters humoral responses to H. pylori and serum pepsinogen I/II ratio.Microbes and Infection.8:52-60
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