Can We Increase Survival of Patients with Gastric Cancer?

Researchers have identified factors that affect life expectancy of patients with stomach cancer, reported in the December issue of Clinical Gastroenterology and Hepatology. Use of these factors to increase early detection of gastric adenocarcinoma could greatly increase survival times among patients.

Gastric cancer is a significant cause of mortality and morbidity worldwide. However, thanks to gastrointestinal endoscopy, cancers can now be detected at early stages, which increases the 5-year survival rate to 90%. Few nationwide long-term assessment studies have estimated the exact potential life-years saved by early detection of gastric cancer, and it’s not clear exactly what factors are associated with survival.

Wei-Ying Chen et al. therefore collected data from 35,576 patients with gastric cancer from the Taiwan Cancer Registry, from 1998 through 2007. They compared patients’ age at diagnosis, life expectancies, and estimated years of life lost based on sex, tumor type, and location.

Chen et al. found a decrease in incidence and lifetime risk of gastric cancer in Taiwan during the past decade. They propose that this could be because of the policy support for Helicobacter pylori eradication by the National Health Insurance in Taiwan, although further studies are needed to prove this.

Gastric cancer was more prevalent among men. The age-specific incidence rates of men are similar to those of women before 50 years of age, but men are about 1.5–2 times more likely to develop such cancer after they are 50 years old. Among the 12,403 women and 23,173 men diagnosed with gastric cancer, nearly 88.6% of patients had adenocarcinoma.

Patients with adenocarcinoma of the gastric cardia had shorter life expectancies and greater estimated years of life lost than those with non-cardia tumors. Women with gastric adenocarcinoma were diagnosed at a younger age and had longer life expectancies, but more estimated years of life lost than men with such tumors.

Importantly, Chen et al. found that when gastric adenocarcinoma was diagnosed at an early stage and cured, women had an estimated 2.62 years of life saved/case and men had 1.97 years of life saved/case.

The early detection rate for gastric cancer is higher than 40% in Japan, whereas it is just around 20% in Western countries. Chen et al. propose that increasing screening and early detection could prevent thousands of life-year loss—especially among women.