Brief Article
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World J Gastroenterol. May 7, 2014; 20(17): 5036-5044
Published online May 7, 2014. doi: 10.3748/wjg.v20.i17.5036
Ecological study of gastric cancer in Brazil: Geographic and time trend analysis
César Augusto Amorim, Jéssica Pronestino Moreira, Luisa Rial, Antonio José Carneiro, Homero Soares Fogaça, Celeste Elia, Ronir Raggio Luiz, Heitor Siffert Pereira de Souza
César Augusto Amorim, Antonio José Carneiro, Homero Soares Fogaça, Celeste Elia, Heitor Siffert Pereira de Souza, Serviço de Gastroenterologia, Departamento de Clínica Médica, Hospital Universitário, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ 21941-913, Brazil
Jéssica Pronestino Moreira, Luisa Rial, Ronir Raggio Luiz, Instituto de Epidemiologia e Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ 21941-913, Brazil
Author contributions: Amorim CA, Carneiro AJ and Fogaça HS participated in the conception and design of the study, the acquisition, analysis, and interpretation of data, and the drafting of the manuscript; Moreira JP, Rial L and Elia C participated in the acquisition, analysis, and interpretation of the data and the drafting of parts of the manuscript; Luiz RR and de Souza HSP participated in the conception and design of the study, obtained funding, analyzed and interpreted data, and critically revised the manuscript for important intellectual content; all authors provided final approval of the submitted version of the manuscript.
Supported by The Brazilian Research Agencies CNPq and FAPERJ (financial support)
Correspondence to: Heitor Siffert Pereira de Souza, MD, Serviço de Gastroenterologia, Departamento de Clínica Médica, Hospital Universitário, Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255, Ilha do Fundão, Rio de Janeiro, RJ 21941-913, Brazil. heitor.souza@gmail.com
Telephone: +55-21-25622669 Fax: +55-21-25622669
Received: October 11, 2013
Revised: January 4, 2014
Accepted: February 26, 2014
Published online: May 7, 2014
Processing time: 208 Days and 7 Hours
Abstract

AIM: To investigate the geographic distributions and time trends of gastric cancer (GC) incidence and mortality in Brazil.

METHODS: An ecological study of the DATASUS registry was conducted by identifying hospitalizations for GC between January 2005 and December 2010. The data included information on the gender, age, and town of residence at the time of hospital admission and death.

RESULTS: The GC rates, adjusted according to available hospital beds, decreased from 13.8 per 100000 in 2005 to 12.7 per 100000 in 2010. The GC rates decreased more among the younger age groups, in which the male-to-female difference also decreased in comparison to the older age groups. Although the lethality rates tended to increase with age, young patients were proportionally more affected. The spatial GC distribution showed that the rates were higher in the south and southeast. However, while the rates decreased in the central-west and south, they increased in the northern regions. A geographic analysis showed higher rates of GC in more urbanized areas, with a coast-to-inland gradient. Geographically, GC lethality overlapped greatly with the hospital admission rates.

CONCLUSION: The results of this study support the hypothesis of a critical role for environmental factors in GC pathogenesis. The declining rates in young patients, particularly males, suggest a relatively recent decrease in the exposure to risk factors associated with GC. The spatial distribution of GC indicates an ongoing dynamic change within the Brazilian environment.

Keywords: Gastric cancer; Ecological study; Hospitalization; Lethality rate

Core tip: Declining rates in young patients and changes in the geographic distribution of gastric cancer suggest a recent decrease in the exposure to risk factors within the Brazilian environment.