ABSTRACT
EPIDEMIOLOGY Despite a remarkable decline in incidence of gastric cancer in the past 50 years, the disease remains the second leading cause of cancer deaths worldwide with over 650,000 cases reported annually. High incidence rates are evident in the Far East (Japan and Korea), parts of Europe (Germany, Poland) and South America (Chile); these vary from 8.2 (USA), 30 (Chile, China, Iceland, Poland, Korea) and 70 (Japan) per 100,000 population. The disease is most common in the fifth to seventh decades of life, with a male to female ratio of 1.6, two-thirds of patients being more than 65 years of age. In the United States, less than 10% of patients are less than 50 years of age. While the overall prognosis with gastric cancer remains poor with less than 15% of patients surviving five years there is recent evidence for an improved outlook for those undergoing surgery with curative intent. Contributing factors might include a decrease in surgical mortality rates, better preoperative selection and earlier diagnosis, improved perioperative care, and perhaps more radical surgery.
