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Gastric cancer incidence and mortality is associated with altitude in the mountainous regions of Pacific Latin America

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Abstract

In Latin America, gastric cancer is a leading cancer, and countries in the region have some of the highest mortality rates worldwide, including Chile, Costa Rica, and Colombia. Geographic variation in mortality rates is observed both between neighboring countries and within nations. We discuss epidemiological observations suggesting an association between altitude and gastric cancer risk in Latin America. In the Americas, the burden of gastric cancer mortality is concentrated in the mountainous areas along the Pacific rim, following the geography of the Andes sierra, from Venezuela to Chile, and the Sierra Madre and Cordillera de Centroamérica, from southern Mexico to Costa Rica. Altitude is probably a surrogate for host genetic, bacterial, dietary, and environmental factors that may cluster in the mountainous regions. For example, H. pylori strains from patients of the Andean Nariño region of Colombia display European ancestral haplotypes, whereas strains from the Pacific coast are predominantly of African origin. The observation of higher gastric cancer rates in the mountainous areas is not universal: the association is absent in Chile, where risk is more strongly associated with the age of H. pylori acquisition and socio-economic determinants. The dramatic global and regional variations in gastric cancer incidence and mortality rates offer the opportunity for scientific discovery and focused prevention programs.

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Acknowledgments

JT is a recipient of an exclusivity scholarship from Fundación IMSS, México. Portions of this study were grant supported in part by NIH CA1255884 (DRM).

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Authors and Affiliations

  1. Unidad de Investigacion en Enfermedades Infecciosas, Instituto Mexicano del Seguro Social, Av Cuauhtemoc 330, Mexico, Mexico

    Javier Torres

  2. University of Vanderbilt, Nashville, TN, USA

    Pelayo Correa & Douglas Morgan

  3. Universidad Catolica de Chile, Santiago, Republic of Chile

    Catterina Ferreccio

  4. Grupo Investigación Epidemiológica, Instituto Nacional de Cancerología, Bogotá, Colombia

    Gustavo Hernandez-Suarez

  5. Prevention and Implementation Group, IARC, Lyon, France

    Rolando Herrero

  6. Ciencias Biologicas, Instituto de Biomedicina, Caracas, Venezuela

    Maria Cavazza-Porro

  7. Hospital de Occidente, Santa Rosa de Copan, Honduras

    Ricardo Dominguez

Authors
  1. Javier Torres
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  2. Pelayo Correa
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  3. Catterina Ferreccio
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  4. Gustavo Hernandez-Suarez
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  8. Douglas Morgan
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Corresponding authors

Correspondence to Javier Torres or Douglas Morgan.

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Javier Torres and Douglas Morgan have contributed equally to this work.

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Torres, J., Correa, P., Ferreccio, C. et al. Gastric cancer incidence and mortality is associated with altitude in the mountainous regions of Pacific Latin America. Cancer Causes Control 24, 249–256 (2013). https://doi.org/10.1007/s10552-012-0114-8

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  • DOI: https://doi.org/10.1007/s10552-012-0114-8

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