Ebook Cancer epidemiology and prevention (4/E): Part 2
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Ebook Cancer epidemiology and prevention (4/E): Part 2
31stomach CancerCATHERINE DE MARTELAND JULIE PARSONNETOVERVIEWStomach cancer is the fifth most common incident cancer worldwide and the third leading Ebook Cancer epidemiology and prevention (4/E): Part 2 cause of cancer death. Almost half of the world's cases occur in Asia, with 42% in China alone. Although the incidence and mortality from stomach cancer are decreasing, global disease burden remains high. Moreover, lire absolute number of eases continues to rise because of population aging. Adenoca Ebook Cancer epidemiology and prevention (4/E): Part 2rcinomas comprise over 90% of gastric malignancies. The adenocarcinomas are further classified according to anatomic location (cardia vs. non-cardia).Ebook Cancer epidemiology and prevention (4/E): Part 2
histology (c.g.. intestinal or diffuse, signet ring or non-signet ring) and most recently by molecular classification. Adenocarcinomas in the stomach31stomach CancerCATHERINE DE MARTELAND JULIE PARSONNETOVERVIEWStomach cancer is the fifth most common incident cancer worldwide and the third leading Ebook Cancer epidemiology and prevention (4/E): Part 2e. Cardia tumors have epidemiological characteristics more similar to those of esophageal adenocarcinoma; the incidence of these tumors IS increasing, particularly in high-income, Western countries. New molecular classification systems have been proposed based on investigations of tumors in high-inc Ebook Cancer epidemiology and prevention (4/E): Part 2ome countries. The Cancer Genome Allas Program has identified four molecular subtypes; (I) tumois positive for Epstein-Barr virus; (2) those marked byEbook Cancer epidemiology and prevention (4/E): Part 2
microsatellite instability; (3) genomically stable tumors: and (4) tumors with chromosomal instability and extensive somatic copynumber aberrations. 31stomach CancerCATHERINE DE MARTELAND JULIE PARSONNETOVERVIEWStomach cancer is the fifth most common incident cancer worldwide and the third leading Ebook Cancer epidemiology and prevention (4/E): Part 2ancer is the eradication of H. pylori with antibiotics. This approach is currently being tested in randomized clinical trials.INTRODUCTIONAt the dawn of the twentieth century, stomach cancer represented an astonishing one-third of all cancers, approximately 1% of hospital admissions, and 2%' of all Ebook Cancer epidemiology and prevention (4/E): Part 2deaths investigated by necropsy (Fenwick and Fenwick. 1903). Although stomach cancer remained the leading cause of cancer death in the world until theEbook Cancer epidemiology and prevention (4/E): Part 2
mid-twentieth century. overall, live rapid decline in stomach cancer throughout live last 100 years has been touted as an "unplanned triumph" (Howson31stomach CancerCATHERINE DE MARTELAND JULIE PARSONNETOVERVIEWStomach cancer is the fifth most common incident cancer worldwide and the third leading Ebook Cancer epidemiology and prevention (4/E): Part 2ls the improvements in nutrition, sanitation, and hygiene in the twentieth century. This steady decrease in incidence over time provides insights into stomach cancer etiology, as well as directions for the ultimate elimination of stomach cancer as an important health problem worldwide.Over 90% of st Ebook Cancer epidemiology and prevention (4/E): Part 2omach cancer cases arc adenocarcinomas arising from the gastnc gland* (Coleman Ct al.. 1993; World Health Organization [WHO], 2010). Other histologicEbook Cancer epidemiology and prevention (4/E): Part 2
types of epithelial stomach cancer include adenosquamous carcinoma, carcinoma with lymphoid stroma (Í.C., medullary carcinoma), hepatoid carcinoma, sq31stomach CancerCATHERINE DE MARTELAND JULIE PARSONNETOVERVIEWStomach cancer is the fifth most common incident cancer worldwide and the third leading Ebook Cancer epidemiology and prevention (4/E): Part 2enchymal tumors, such as leiomyoma, schwannoma, and Kaposi sarcoma in immunosuppressed patients (WHO. 2010). Secondary tumors are rare, the stomach being one of live five least common metastatic sites (Disibio and French. 2008).Because they represent the vast majority of gastric tumors, this chapter Ebook Cancer epidemiology and prevention (4/E): Part 2 focuses on adenocarcinomas of the stomach, including cancers of both the gastric cardia (ICD-0 code 16.0) and non-carđia (ICD-0 codes Cl6.1-Cl6.6) (WEbook Cancer epidemiology and prevention (4/E): Part 2
HO. 2013).DISEASE BURDENAccording to GLOBOCAN, an estimated 952.000 new cases of gastric cancer occurred worldwide in 2012 (Ferlay et al.. 2013). maki31stomach CancerCATHERINE DE MARTELAND JULIE PARSONNETOVERVIEWStomach cancer is the fifth most common incident cancer worldwide and the third leading Ebook Cancer epidemiology and prevention (4/E): Part 2with 553.000 cases occurring in Eastern Asia, and nearly half of live total number (405.000 cases or 42.5% of the total) in China alone. Global incidence and death nites arc shown in Figures 31—la and 31—lb. Europe contributed nearly 15% of the global burden <140.000 cases), and Latin America contri Ebook Cancer epidemiology and prevention (4/E): Part 2buted a further 6% (61,000 cases) (Fcrlay cl al.. 2013). Eastern Europe and the Andes arc areas w ith particularly high risk. In the United States, thEbook Cancer epidemiology and prevention (4/E): Part 2
e American Cancer Society predicts that 26.370 new cases of stomach cancer (16.480 in men and 9890 in women) will be diagnosed in 2016 with 10.730 dea31stomach CancerCATHERINE DE MARTELAND JULIE PARSONNETOVERVIEWStomach cancer is the fifth most common incident cancer worldwide and the third leading Ebook Cancer epidemiology and prevention (4/E): Part 2e and mortality, in the United States.Survival rates for stomach cancer arc generally poor. A recent international comparison of survival in 279 population-based cancer registries in 67 countries (Allemani et al.. 2015) shows that the 5-year age standardized net survival from stomach cancer (i.e.. l Ebook Cancer epidemiology and prevention (4/E): Part 2ive proportion of cancer patients who survive 5 years, after eliminating the background mortality due to other causes) ranges from 15% to 35%’ for aduEbook Cancer epidemiology and prevention (4/E): Part 2
lts. Survival is considerably higher in Japan and South Korea (50%-60%), where systematic screening allows the early detection and surgical treatment 31stomach CancerCATHERINE DE MARTELAND JULIE PARSONNETOVERVIEWStomach cancer is the fifth most common incident cancer worldwide and the third leading Ebook Cancer epidemiology and prevention (4/E): Part 20% reduction in mortality with screening (Hamashima cl al.. 2013; Hamashiina Ct al.. 2015). The slope of improvement in mortality has remained relatively constant since the early 1970s. prior to the onset of widespread endoscopic and radiographic screening programs (Whitlock. 2012).Because of its hi Ebook Cancer epidemiology and prevention (4/E): Part 2gh case-fatality, gastric cancer accounts for a larger fraction of cancer deaths than incident cases globally (8.8% versus 6.8%). Despite its declininEbook Cancer epidemiology and prevention (4/E): Part 2
g incidence, gastric cancer remains live third leading cause of cancer death worldwide (723.0CX) deaths estimated per annum), after lung and liver can31stomach CancerCATHERINE DE MARTELAND JULIE PARSONNETOVERVIEWStomach cancer is the fifth most common incident cancer worldwide and the third leading Ebook Cancer epidemiology and prevention (4/E): Part 2ical type of gastnc cancer. The worldwide total number of lymphomas of gastric origin in 2012 was estimated to be 18.000. or less than 2% the number of adenocarcinomas (Plummer Ct al.. 2016). Other gastric histologic types arc even less common.CLASSIFICATIONEpidemiologic studies over the last 50 yea Ebook Cancer epidemiology and prevention (4/E): Part 2rs have classified gastric cancers according Io several systems, beginning with histopathology593594PART IV. CANCERS BY TISSUE OF ORIGINFigure 31-la,Ebook Cancer epidemiology and prevention (4/E): Part 2
Estimated worldwide stomach cancer incidence rates per 100.000 in men for the year 2012 Sourer. GLOBOCAN 2012. IARC. WHOFigure 31—I b. Estimated world31stomach CancerCATHERINE DE MARTELAND JULIE PARSONNETOVERVIEWStomach cancer is the fifth most common incident cancer worldwide and the third leading Ebook Cancer epidemiology and prevention (4/E): Part 2ation in lire early 1990s. Molecular classification systems have recently been proposed belt have not yet been integrated into epidemiologic studies, nor arc molecular markers available at this point from population-based tumor registries.Gastric Anatomy and FunctionGrossly, the stomach has four ana Ebook Cancer epidemiology and prevention (4/E): Part 2tomical regions: the cardia, the fundus. the body, and the pylorus, as shown in Figure 31-2. The gastric cardia (also known as the gastroesophageal |GEbook Cancer epidemiology and prevention (4/E): Part 2
E| or esophagogastric junction (WHO. 2010J) is a narrow circular band. 1.5-3 cm wide.located at the junction where tlie tubular esophagus joins the st31stomach CancerCATHERINE DE MARTELAND JULIE PARSONNETOVERVIEWStomach cancer is the fifth most common incident cancer worldwide and the third leading Ebook Cancer epidemiology and prevention (4/E): Part 2sections of the stomach that secrete acid, comprise the majority of the stomach The pylorus is the section of the stomach that transitions from stomach to the small bowel; the proximal portion of the pylorus located within the stomach and before the pyloric sphincter is known as the antrumAll areas Ebook Cancer epidemiology and prevention (4/E): Part 2of the stomach are covered with mucus-secreting foveolar and columnar epithelial cells lining the luminal surfaces and invaginations called gastric piEbook Cancer epidemiology and prevention (4/E): Part 2
ts. Midway down the pits are the gastric stem cells; at the base of the pits are the glands. Secretory glands in thestomach CancerFigure 31-2. Cancer 31stomach CancerCATHERINE DE MARTELAND JULIE PARSONNETOVERVIEWStomach cancer is the fifth most common incident cancer worldwide and the third leading Ebook Cancer epidemiology and prevention (4/E): Part 2tability, GS = gcnomically MJiNc Stw/tv: The Cancer Genome Allis Research Network, Comprehensive mntocular characterization of gastric adenocarcinoma. Adapted from Ntuure 20I4:$13(75I7):202~209.body and fundus of (he stomach produce hydrochloric acid and intrinsic factor (parietal cells), serotonin Ebook Cancer epidemiology and prevention (4/E): Part 2(enteroendocrine or Kulchitsky cells), and pepsinogen, leptin, and lipase (chief cells). Enteroendocrine cells tn the gastric antrum secrete gastrin (Ebook Cancer epidemiology and prevention (4/E): Part 2
G cells) and somatostatin (D cells). Cardiac and pyloric glands have neither parietal nor chief cells and largely secrete mucus. The length of the carGọi ngay
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