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Original research
Population-based investigation of common and deviating patterns of gastric cancer and oesophageal cancer incidence across populations and time
  1. Mengmeng Li1,
  2. Jin Young Park2,
  3. Mahdi Sheikh2,
  4. Violet Kayamba2,3,
  5. Harriet Rumgay2,
  6. Mazda Jenab2,
  7. Clement Tetteh Narh2,4,
  8. Behnoush Abedi-Ardekani2,
  9. Eileen Morgan2,
  10. Catherine de Martel2,
  11. Valerie McCormack2,
  12. Melina Arnold2
  1. 1Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
  2. 2Branches of Environment and Lifestyle Epidemiology, Cancer Surveillance and Genomics, International Agency for Research on Cancer, Lyon, France
  3. 3Department of Medicine, University of Zambia School of Medicine, Lusaka, Zambia
  4. 4Department of Epidemiology and Biostatistics, University of Health and Allied Sciences, Ho, Ghana
  1. Correspondence to Dr Valerie McCormack, International Agency for Research on Cancer, Lyon 69372, France; mccormackv{at}


Background The subtypes of gastric cancer (GC) and oesophageal cancer (EC) manifest distinct epidemiological profiles. Here, we aim to examine correlations in their incidence rates and to compare their temporal changes globally, both overall and by subtype.

Methods Long-term incidence data were obtained from population-based registries available from the Cancer Incidence in Five Continents series. Variation in the occurrence of EC and GC (overall and by subtype) was assessed using the GC:EC ratio of sex-specific age-standardised rates (ASR) in 2008–2012. Average annual per cent changes were estimated to assess temporal trends during 1998–2012.

Results ASRs for GC and EC varied remarkably across and within world regions. In the countries evaluated, the GC:EC ratio in men exceeded 10 in several South American countries, Algeria and Republic of Korea, while EC dominated in most sub-Saharan African countries. High rates of both cardia gastric cancer and oesophageal squamous cell carcinoma (ESCC) were observed in several Asian populations. Non-cardia gastric cancer rates correlated positively with ESCC rates (r=0.60) and negatively with EAC (r=−0.79). For the time trends, while GC incidence has been uniformly decreasing by on average 2%–3% annually over 1998–2012 in most countries, trends for EC depend strongly on histology, with several but not all countries experiencing increases in EAC and decreases in ESCC.

Conclusions Correlations between GC and EC incidence rates across populations are positive or inverse depending on the GC subsite and EC subtype. Multisite studies that include a combination of populations whose incidence rates follow and deviate from these patterns may be aetiologically informative.

  • gastric cancer
  • oesophageal cancer
  • epidemiology
  • gastric adenocarcinoma

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Contributors ML performed all analyses under the supervision of MA, VMcC and JYP. All authors contributed to the discussion. ML drafted the first version of the text. ML and VMcC are overall guarantors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.