Stomach Cancer: A Descriptive Epidemiology

Stomach Cancer: A Descriptive Epidemiology

Personal Characteristics

Stomach cancer affects different demographics with a great deal of variation. In the period from 2002 to 2006, over two-thirds (64.3%) of all newly diagnosed stomach cancers occurred in patients over the age of 65 (ACS 2009; Horner et al. 2009). The age-adjusted incidence rate for the period was 7.9 new diagnoses per 100,000 men and women, with men experiencing incidence rates almost exactly twice that of women when all racial groups were combined, a trend that continued in mortality rates for the period (Horner et al. 2009). Overall mortality rates are projected at approximately half that of the incidence rate for the same period (ACS 2009). Overall prevalence stomach cancer was 64,122 as of 2006, and given rates of incidence and mortality in the interceding years, this number has remained relatively stable (Horner et al. 2009). Incidence, prevalence, and mortality have all dropped significantly in the past seventy-five years, however, sue to advances in health and care (NCI 2008).

Incidence and mortality is also highly influenced by race. The highest rate of incidence for stomach cancer in the United States was among the Asian/Pacific Islander demographic, with 18 out of every 100,000 men and 10 out of every 100,000 women being diagnosed during the most recent study (Horner et al. 2009; CDC 2009). The rate of mortality, however, is slightly higher in African-Americans, the demographic with the second-highest rate of incidence in both men and women (NCI 2009; Horner et al. 2009). The general downward trend in the rates of incidence and mortality in African-Americans has also been slightly shallower than in other demographics, though not as volatile as American Indians (NCI 2009).

Overall prevalence of stomach cancer is approximately .89% according to the data gathered by the most recent comprehensive study, meaning that one out of every one-hundred-and-thirteen men and women will be diagnosed with stomach cancer at some point in their lives, with the vast majority of these diagnoses coming after the age of sixty-five (Horner et al. 2009; NCI 2009). Religion and occupational differences do not appear to have been statistically significant factors in the rates of prevalence, incidence, or mortality of stomach cancers. race and gender, however, are both hugely influential, especially for rates on incidence and prevalence (Horner et al. 2009; ACS 2009). Both gender and race also have a definite and measurable effect on mortality rates, though this effect -- especially for gender -- is remarkably smaller in mortality rates than it is in the rates of prevalence and incidence (Horner et al. 2009).

Other personal characteristics that appear to contribute to the incidence and mortality rates of stomach cancer across all ages and races, though with heightened influence in demographics already identified as at-risk, include tobacco use and, interestingly, access to antibiotics (ACS 2009). This last, along with the advent of refrigeration for food storage -- which allowed fresh fruits and vegetables to be stored longer and consumed more regularly -- are both credited for reducing incidence, prevalence, and mortality of stomach cancer over the past seventy-five years, as the lack of access to antibiotics and fresh produce has been linked to higher rates in individuals and populations (ACS 2009). The overall five-year relative survival rate for stomach cancer is 25.7%, with women having a slightly higher survival rate overall than men (Horner et al. 2009).

Section 2: Geographical Characteristics

Racial mortality and incidence rates seem to have a direct relationship with certain geographic trends in stomach cancer. Hawaii, which has a much higher proportion of Asian/Pacific Islanders (for obvious reasons) than other states also has a much higher mortality rate from stomach cancer (NCHS 2009). The mortality rate in Hawaii, which was 7.17% when adjusted for age, is a full one-and-a-half percentage points above the second highest rate, which is found in Washington, D.C. (NCHS 2009). Racial demographics can also be seen as influential in the other geographical data concerning incidence and mortality of stomach cancer, as these trends provide some ot he only commonalities between identified states.

Specifically, large populations of African-Americans -- who it will be remembered had the highest mortality rate from stomach cancer -- exist in the states that have the highest mortality rates. This is not especially the case with Hawaii, but is certainly true in Washington, D.C. Louisiana -- especially New Orleans and the surrounding areas -- also contains a large proportion of African-Americans, and has the third highest mortality rate from stomach cancer of all of the United States (NCHS 2009). New Mexico and Alaska buck this trend, as they also possess relatively high mortality rates from stomach cancer (NCHS 2009). Other regional demographics, however, help to bear out the racial factor as one of the primary determinants of geographical trends in stomach cancer mortality.

The Southern region especially contains the highest rates of incidence and mortality, especially in the states stretching East from New Mexico to the Atlantic (Texas, Louisiana, Arkansas, Mississippi, Alabama, Georgia, and South Carolina) (NCHS 2009). The New England area states -- Connecticut, Massachusetts, Rhode Island, and New York especially, also have increased mortality rates when compared to the rest of the nation (NCHS 2009). The Midwest as a whole, on the other hand, has very low rates of incidence and mortality, as do the northernmost New England states -- Vermont, New Hampshire, and Maine (NCHS 2009). These regions tend to be more homogenously white in their racial make-up then the regions and states with higher rates of stomach cancer mortality.

The inclusion of California, Nevada, and Illinois in the states with the highest rates of mortality and incidence of stomach cancer shows another facet of the geographic breakdown of stomach cancer incidence and mortality rates. These states are all regionally isolated in their rates, being surrounded by states with significantly lower rates of stomach cancer mortality (NCHS 2009). These states also have large urban areas -- the largest in the United States, as a matter of fact, when Boston and New York City (which reside in states already noted for their increased mortality rates) are taken out of the picture -- such as Las Vegas and Reno, Los Angeles, San Diego, and San Francisco, and Chicago. Urban areas are home to larger proportions of most minority groups, including (and perhaps especially) African-Americans, so again there is a racial explanation for the observed geographical demographics of stomach cancer incidence and mortality rates (NCHS 2009). The slightly higher relative mortality rates in North Dakota and New Mexico remain the only states for which this explanation does not appear to be applicable.