ABSTRACT
Gastric Cancer Stephen A. Shiver; Brian W. Loggie Scope and Epidemiology The incidence of gastric cancer in the United States has decreased approximately
fourfold over the last 60 years.1 Though the exact cause of this decline is unknown, it represents a dramatic trend in cancer epidemiology. Whereas it was once the country’s leading cause o f cancer related mortality, it is now ranked seventh (Table 7.1).2 Despite the declining incidence, the disease continues to cause signifi cant morbidity and mortality. In 1998, there were 22,600 newly diagnosed cases of gastric cancer in the United States and 13,700 deaths attributed to the disease.2 An exception to the declining overall rate o f gastric malignancy is adenocarcinoma aris ing in the gastric cardia. The incidence of cancer arising at this site has rapidly increased, paralleling the rising incidence of distal esophageal and gastroesophageal junction tumors.3
