Opposing time trends of gastric cardia cancer and duodenal ulcer

Authors T.N. Milosavljevic, I.R. Jovanovic, M.N. Krstic, M.M. Ugljesic, D.S. Popovic,P.D. Dugalic, R. Krstic,S.P. Djuranovic,, M. Spuran, N.S. Mijalkovic ..


Background: Most countries have registrated decline in
distal (antrum and corpus) gastric cancer incidence and
mortality. On the other hand, adenocarcinoma of the gastric
cardia has been increasing with the unknown risk factor
being responsible. This observation may or may not be
in the relation to the Helicobacter pylori infection.
Aims: To study the time trends of Helicobacter pylori related
diseases in the past decade
Material and methods: This study was based on endoscopy
reports of the hospitalized patients collected in the Department
of the diagnostic endoscopy; Clinic of gastroenterology
and hepatology- Belgrade between 1987 and 1997.
Results: From 1987 to 1997, hospitalisation rates for gastric
ulcer as well as distal gastric cancer fell, while the hospitalization
rate for gastro-oesophageal reflux disease and
duodenal ulcer didnt change. At the same time hospitalisation
rate for gastric cardia cancer rose. When this is compared
to the time trend of the duodenal ulcer significant
difference between those two trends was observed (P<0.01).
Conclusion: Opposing time trends of duodenal ulcer versus
gastric cardia cancer is consistent with hypothesis that
the declining infecton rates for Helicobacter pylori, due to
the active therapy, in the general populaton may acctualy have led to a rise in the occurence of proximal gastric cancer
new developments in molecular biology may provide
better understanding of the topographic variants of gastric
cancer and the potential role of Helicobacter pylori-associated
gastritis with atrophic and metaplastic sequelae, distinct
from Barretts oesophagus.
Key words: gastric cardia cancer, Helicobacter pylori, gastroesophageal
reflux disease (GERD), time trends
Original Articles