ABSTRACT
Gastric cancer accounts for approximately 6 per cent of all cancer deaths in the UK, a percentage which comprises almost 10 000 people. Within Europe there are approximately 207 000 new cases each year and although the mortality from gastric cancer is reducing worldwide it remains the second commonest cause of cancer death. There are
dramatic geographical variations in the incidence of gastric cancer characterized by reducing rates in Westernized countries such as the UK (current incidence 8/100 000) while countries such as Japan, Brazil, Portugal and Lithuania continue to have a high incidence of the disease (50-100/100 000). The pattern of the disease also differs between countries; in the UK and USA (Fig. 25.1) tumours of the proximal stomach and gastro-oesophageal junction
Incidence 602 Aetiology 603 Diagnosis 603 Pathology 604 Molecular biology 604
Staging 605 Treatment 606 Adjuvant chemotherapy 611 Future directions 612 References 612
Figure 25.1 Incidence of gastric cancer by age and racial origin in USA (Surveillance, Epidemiology, and End Results (SEER) Program)
now outnumber antral cancers. This change in position of the tumours is not observed to the same extent in high incidence regions.
