A Few Main Risk Factors Account for Stomach Cancer
Although numerous reports have identified risk factors for these diseases, 'no study has comprehensively examined their contributions to the cancer burden in the general population,' lead author Dr. Lawrence S. Engel, from Memorial Sloan-Kettering Cancer Center in New York, and colleagues note.
The current study involved 1143 patients with esophagus or stomach cancer and 695 healthy people. The patients were diagnosed between 1993 and 1995 in Connecticut, New Jersey, or Washington.
The researchers looked at the four main types of cancer that involve the esophagus and stomach: adenocarcinoma of the esophagus, squamous cell cancer of the esophagus, adenocarcinoma of 'cardia' region of the stomach, and adenocarcinoma of other stomach areas.
The new findings are reported in the Journal of the National Cancer Institute.
Being overweight accounted for the greatest percentage of esophagus adenocarcinomas--41 percent, the authors state. The next biggest contributor--ever smoking--accounted for 40 percent of cases. Together, being overweight, ever smoking, reflux of stomach contents into the esophagus, and low fruit and vegetable consumption accounted for 79 percent of cases.
Alcohol consumption was responsible for the greatest percentage of esophageal squamous cell cancers--72 percent. Nearly 90 percent of cases could be accounted for by alcohol use, a history of ever smoking, and low fruit and vegetable intake.
For stomach cardia adenocarcinomas, smoking was the biggest contributor, responsible for 45 percent of cases. A history of ever smoking and being overweight together accounted for 56 percent of cases.
For other stomach adenocarcinomas, increased nitrite intake, a compound found in smoked foods, accounted for the greatest percentage of cases--41 percent, the researchers point out.
The rapid rise in the rate of new cases of stomach and esophagus cancers that has occurred in Western populations appears to result from increases in the prevalence of several risk factors that people are capable of changing, the authors note.
'Efforts to reduce the prevalence of being overweight, having gastroesophageal reflux, and smoking and to improve diet could reverse this troubling cancer trend,' they add.
SOURCE: Journal of the National Cancer Institute, September 17, 2003.
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