OBJECTIVETo explore the major risk factors for upper gastrointestinal cancer in high occurrence areas of esophageal and gastric cancer in China.

METHODSFour high occurrence areas of esophageal cancer, namely Cixian and Shexian from Hebei province, Linxian from Henan province, Feicheng from Shandong province, and Zhuanghe from Liaoning province, which is a high occurrence area of gastric cancer, were selected for the study. The newly-diagnosed cases whose date of onset were after January 1st, 2009 were selected from the Cancer Registration Database in each district, and 751 cases diagnosed as cancers in lower segment of esophagus, cardiac and other subsite of stomach were randomly recruited. 2253 matched controls were selected to pair the cases at the ratio of 3:1. The relative information of the study objects were collected from the face-to-face interviews with trained staff by designed questionnaires, and the data was input by EpiData software. Statistic software SPSS 13.0 was applied to conduct both univariate and multivariate logistic regression analysis to evaluate odd ratios (OR) and 95% confident interval (CI).

RESULTSAs univariate analysis shown, 66 objects in case group had irregular diet habit; while 90 in control group had (OR = 3.177; 95%CI: 2.127 - 4.745). A higher percentage in case group (83 objects) preferred fried food in comparison with only 214 in control group did (OR = 3.190; 95%CI: 2.061 - 4.927). 369 objects in case group, but only 119 in control group had history of gastrointestinal diseases (OR = 14.660; 95%CI: 11.342 - 18.948). 282 objects in case group had history of gastroesophageal reflux disease (GERD), which was much higher than the percentage in control group (432 objects), with OR = 3.137 (95%CI: 2.546 - 3.864). All the above factors could increase the risk for upper gastrointestinal cancer. 387 objects in case group and 1278 in control group reported they preferred fresh vegetables in daily diet, which was found to be a protective factor (OR = 0.609; 95%CI: 0.473 - 0.785). As multivariate analysis shown, history of gastrointestinal tract diseases (OR = 21.420; 95%CI: 15.484 - 29.632), irregular food diet (OR = 3.097; 95%CI: 1.740 - 5.514), pickled food (OR = 3.005; 95%CI: 1.873 - 4.819), and GERD (OR = 2.261; 95%CI: 1.673 - 3.057) were found to be risk factors for upper gastrointestinal cancer; while frequent fresh-vegetable diet was a protective factor (OR = 0.562; 95%CI: 0.396 - 0.800).

CONCLUSIONIrregular lifestyle and unhealthy diet habit could be the major risk factors for upper gastrointestinal cancers among the residents from high occurrence areas of esophageal cancer and gastric cancer in China.

Case-Control Studies ; China ; epidemiology ; Esophageal Neoplasms ; epidemiology ; etiology ; Feeding Behavior ; Gastrointestinal Neoplasms ; epidemiology ; etiology ; Humans ; Life Style ; Risk Factors ; Stomach Neoplasms ; epidemiology ; etiology ; Surveys and Questionnaires

OBJECTIVETo explore the application value of correspondence analysis in ecological study.

METHODSWe adopted correspondence analysis method to analyze the relationship between the amount of food intake in some cities in China and the male gastric carcinoma mortality.

RESULTSAccording to scatter plots of row and column points, there were regional differences among the male gastric carcinoma mortality in different cities of China.

CONCLUSIONThe scatter plot of row and column points indicated directly that there were regional differences among the male gastric carcinoma mortality in different cities of China. Males from the Southern part of the country ate more rice and salt, less wheaten food and fewer light vegetables than those from the northern parts, suggesting that there might be some carcinogenic factors in some food stuff involved.

Carcinoma ; etiology ; mortality ; China ; epidemiology ; Diet Surveys ; Humans ; Male ; Stomach Neoplasms ; etiology ; mortality

Case-Control Studies ; China ; epidemiology ; Female ; Humans ; Male ; Risk Factors ; Stomach Neoplasms ; etiology

OBJECTIVETo compare clinically relevant postoperative complications after open, laparoscopic, and robotic gastrectomy for gastric cancer.

METHODSClinical data of patients with gastric cancer who underwent gastrectomy between January 1, 2014 and October 1, 2016 at Chinese People's Liberation Army General Hospital were analyzed retrospectively. All the patients were diagnosed by upper endoscopy and confirmed by biopsy without distant metastasis. They were confirmed with R0 resection by postoperative pathology. Patients with incomplete data were excluded. The complications among open group, laparoscopic group and robotic group were compared. The continuous variables were analyzed by one-way ANOVA, and categorical variables were analyzed by χtest or Fisher exact test.

RESULTSA total of 1 791 patients (1 320 males and 471 females) were included in the study, aged from 17 to 98 (59.0±11.6) years, comprising 922 open, 673 laparoscopic and 196 robotic gastrectomies. There were no significant differences among three groups in baseline data (gender, age, BMI, comorbidity, radiochemotherapy) and some of operative or postoperative data (blood transfusion, number of lymph node dissection, combined organ resection, resection site, N stage, postoperative hospital stay). The blood loss in laparoscopic and robotic groups was significantly lower than that in open group[(185.7±139.6) ml and (194.0±187.6) ml vs. (348.2±408.5) ml, F=59.924, P=0.000]. The postoperative complication occurred in 197 of 1 791(11.0%) patients. The Clavien-Dindo II(, III(a, III(b, IIII(a, and IIIII( complications were 5.5%, 4.0%, 1.2%, 0.1%, and 0.2% respectively. The anastomotic leakage (2.4%), intestinal obstruction(1.3%) and pulmonary infection(1.2%) were the three most common complications, followed by wound infection(0.8%), cardiovascular disease(0.7%), anastomotic bleeding (0.7%), delayed gastric emptying (0.6%), duodenal stump fistula(0.5%), intraperitoneal hemorrhage (0.5%), pancreatic fistula (0.3%), intra-abdominal infection(0.2%), chylous leakage (0.1%) and other complications(1.7%). There were no significant differences among three groups as the complication rates of open, laparoscopic and robotic gastrectomy were 10.6%(98/922), 10.8%(73/673) and 13.3%(26/196) respectively (χ=1.173, P=0.566). But anastomotic leakage occurred more common after laparoscopic and robotic gastrectomy compared to open gastrectomy [3.1%(21/673) and 5.1%(10/196) vs. 1.3%(12/922), χ=12.345, P=0.002]. The rate of cardiocerebral vascular diseases was higher in open group[1.3%(12/922) vs. 0.1%(1/673) and 0, χ=8.786, P=0.012]. And the rate of anastomotic bleeding was higher in robotic group [2.0%(4/196) vs. open 0.4%(4/922) and laparoscopic 0.6%(4/673), χ=6.365, P=0.041]. In view of Clavien-Dindo classification, III(a complications occurred more common in laparoscopic group [5.5%(37/673) vs. open 3.3%(30/922) and robotic 2.6%(5/196), χ=6.308, P=0.043] and III(b complications occurred more common in robotic group [3.1%(6/196) vs. open 1.1%(10/922) and laparoscopic 0.7%(5/673), χ=7.167, P=0.028].

CONCLUSIONSMorbidities of postoperative complications are comparable among open, laparoscopic and robotic gastrectomy for gastric cancer. However, in consideration of the high difficulty of anastomosis, the minimally invasive surgery should be performed by more experienced surgeons.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anastomotic Leak ; epidemiology ; etiology ; Blood Loss, Surgical ; statistics & numerical data ; Cerebrovascular Disorders ; epidemiology ; etiology ; Chylous Ascites ; epidemiology ; etiology ; Comorbidity ; Comparative Effectiveness Research ; Duodenal Diseases ; epidemiology ; etiology ; Female ; Gastrectomy ; adverse effects ; methods ; Gastrointestinal Hemorrhage ; epidemiology ; etiology ; Gastroparesis ; epidemiology ; etiology ; Gastroscopy ; Hemoperitoneum ; epidemiology ; etiology ; Humans ; Intestinal Fistula ; epidemiology ; etiology ; Intraabdominal Infections ; epidemiology ; etiology ; Laparoscopy ; adverse effects ; Length of Stay ; Lymph Node Excision ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; etiology ; Postoperative Hemorrhage ; epidemiology ; etiology ; Postoperative Period ; Respiratory Tract Infections ; epidemiology ; etiology ; Retrospective Studies ; Risk Assessment ; Robotic Surgical Procedures ; adverse effects ; Stomach Neoplasms ; surgery ; Surgical Wound Infection ; epidemiology ; etiology

Gastric stump cancer was initially defined as a carcinoma of the stomach occurring more than 5 years after surgery for gastric or duodenal benign disease. In recent years, as the number of total gastrectomy for benign disease has gradually decreased and the gastric cancer detection and operation rate have annually increased, residual recurrence of primary gastric cancer more than 10 years after gastric cancer surgery has also been considered as gastric stump cancer. The incidence of gastric stump cancer is increasing annually. The epidemiological characteristics of this form of cancer are also developing, and they show a higher incidence in males compared to females. The incidence has been affected following digestive tract reconstruction, and the risk increases in patients who undergo Billroth II( reconstruction. The interval of onset is related to the benign and malignant condition of primary disease, and the incidence increases after 10 years of early gastric cancer surgery. Lymph node metastasis pattern in gastric stump cancer is different from that in primary gastric cancer as the primary operation may destroy normal lymph flow. Many factors are known to cause gastric stump cancer, mainly duodenal gastric reflux, Helicobacter pylori infection, and gastric mucosal barrier dysfunction; however, the mechanism is not clear. It is expected to reduce the incidence of gastric stump cancer by taking precautionary measures against different inducements, which also has some guiding significance for the treatment and prognosis of gastric cancer.
Female ; Gastrectomy ; Gastric Stump ; pathology ; surgery ; Gastroenterostomy ; Humans ; Incidence ; Male ; Neoplasm Recurrence, Local ; Risk Factors ; Stomach Neoplasms ; epidemiology ; etiology ; surgery

OBJECTIVE: To explore the risk factors of gastric cancer in the rural area of Henan province. METHODS: Three hundred and twenty-five families with gastric cancer and 325 control families (1010 persons in each group) were selected among the rural residents in 4 counties of Henan province. Totally 2020 people were surveyed and assessed using population-based case-control family study. RESULTS: Gastric cancer was related to stomach upset, irregular dietary, hobby for salty taste, residual food, and history of mental stimulus. CONCLUSION Stomach upset, irregular dietary, hobby for salty taste, residual food, and history of mental stimulus are the risk factors of gastric cancer.
Case-Control Studies ; China ; epidemiology ; Feeding Behavior ; Humans ; Risk Factors ; Rural Population ; Stomach Neoplasms ; etiology ; genetics ; Surveys and Questionnaires

Helicobacter pylori can cause variety of upper gastrointestinal disorders such as peptic ulcer, mucosa associated lymphoid tissue (MALT)-lymphoma, and gastric cancer. The prevalence of H. pylori infection has significantly decreased in Korea since 1998 owing to active eradication of H. pylori. Along with its decrease, the prevalence of peptic ulcer has also decreased. However, the mean age of gastric ulcer increased and this is considered to be due to increase in NSAID prescription. Gastric cancer is one of the leading causes of cancer deaths in Korea and Japan, and IARC/WHO has classified H. pylori as class one carcinogen of gastric cancer. Despite the decreasing prevalence of H. pylori infection, the total number of gastric cancer in Korea has continuously increased from 2006 to 2011. Nevertheless, the 5 year survival rate of gastric cancer patients significantly increased from 42.8% in 1993 to 67% in 2010. This increase in survival rate seems to be mainly due to early detection of gastric cancer and endoscopic mucosal dissection treatment. Based on these findings, the prevalence of peptic ulcer is expected to decrease even more with H. pylori eradication therapy and NSAID will become the main cause of peptic ulcer. Although the prevalence of gastric cancer has not changed along with decreased the prevalence of H. pylori, gastric cancer is expected to decrease in the long run with the help of eradication therapy and endoscopic treatment of precancerous lesions.
Anti-Bacterial Agents/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Gastrointestinal Diseases/complications/*epidemiology ; Helicobacter Infections/complications/drug therapy/epidemiology ; Humans ; Lymphoma, B-Cell, Marginal Zone/epidemiology ; Peptic Ulcer/epidemiology/etiology ; Prevalence ; Stomach Neoplasms/etiology/mortality/pathology

OBJECTIVETo explore the role of green tea in decreasing the risks of gastric cancer, liver cancer, esophageal cancer among alcohol drinkers or cigarette smokers.

METHODSA population based case-control study was conducted in Taixing, Jiangsu province.

RESULTSIn Taixing city, identified cases of stomach, liver and esophageal cancers were chosen with informed consent. The numbers were 206, 204, 218 respectively. Controls were chosen from normal population having lived in the area for longer than 10 years, also with informed consent. Green tea drinking seemed to have decreased 81%, 78%, 39% risk for the development of gastric cancer, liver cancer and esophageal cancer among alcohol drinkers. It might also have decreased 16%, 43%, 31% on the risks of developing the three kinds of cancers among cigarette smokers. Interaction assessment showed that drinking green tea could significantly decrease the risk of gastric cancer and liver cancer among alcohol drinkers, with ORs of interaction item 0.23 (95% CI: 0.10 - 0.55) and 0.25 (95% CI: 0.11 - 0.57) respectively.

CONCLUSIONHabit of drinking green tea seemed to have significant protective effects on the development of both gastric and liver cancer among alcohol drinkers while, green tea also having some protective effect on esophageal cancer among alcohol drinkers and on three kinds of cancers among cigarette smokers.

Adult ; Aged ; Alcohol Drinking ; adverse effects ; Case-Control Studies ; China ; epidemiology ; Digestive System Neoplasms ; epidemiology ; etiology ; prevention & control ; Esophageal Neoplasms ; etiology ; Female ; Flavonoids ; administration & dosage ; Humans ; Liver Neoplasms ; epidemiology ; etiology ; prevention & control ; Male ; Middle Aged ; Phenols ; administration & dosage ; Polyphenols ; Risk ; Smoking ; adverse effects ; Stomach Neoplasms ; epidemiology ; etiology ; prevention & control ; Tea ; chemistry

OBJECTIVETo understand the epidemiologic features and etiology of Helicobacter pylori (H. pylori) infection in China so as to provide evidence for the development of preventive measures on H. pylori infection and related diseases.

METHODSMeta-analysis was used to evaluate the data extracted from 1990 - 2002 published papers on the epidemiology of H. pylori infection in China.

RESULTSThe average infection rate of H. pylori infection in China was 58.07%, with 50% in 10 to 20 year-olds. Significant intrafamilial clustering was observed. H. pylori infection was a risk factor to develop gastrointestinal disease.

CONCLUSIONSH. pylori infections in Chinese were common and extensively distributed, which might due to close contact between family members.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Family ; Female ; Helicobacter Infections ; complications ; epidemiology ; Helicobacter pylori ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Stomach Neoplasms ; etiology

OBJECTIVETo set up a mathematic model for determining individual risk and population risk of gastric carcinoma.

METHODSBased on principles and methods of probability and fuzzy mathematics, a case-control study was quantified and a mathematic model for the screening of gastric carcinoma was set up. Using two different calculation methods of weight coefficients, the thresholds were identified as 0.20 and 0.17, respectively. This mathematic model was then used to examine 63 cases and 693 normal persons.

RESULTSThe sensitivities and specificities were 69% and 63%. The different calculative methods of weight coefficients did not affect the results of the identification.

CONCLUSIONThe sensitivities and specificities were satisfactory indicating that it was convenient, feasible, economic and could meet the contented screening rate. It could be used to determinate the risk for gastric carcinoma both on individual and on population.

Case-Control Studies ; China ; epidemiology ; Female ; Humans ; Male ; Mass Screening ; methods ; Models, Theoretical ; Risk Assessment ; Risk Factors ; Sensitivity and Specificity ; Stomach Neoplasms ; epidemiology ; etiology ; prevention & control ; Surveys and Questionnaires