Sub-site specific time trends of carcinoma stomach in North Kerala--a retrospective analysis.

ABSTRACT

The time trends in the incidence of carcinoma stomach in the various sub-sites in stomach have been documented in the western population. The incidence of carcinoma of gastric cardia is found to be increasing, while that of the antrum is seen to be decreasing. Data from tropics is lacking on this aspect. This retrospective study was performed to look into the site-specific time trends of carcinoma stomach. Endoscopy registers maintained in the Department of Gastroenterology, Medical College, Kozhikode, Kerala in South India were screened over the period of 20 years from 1982 to 2001. Histopathologically confirmed cases of adenocarcinoma were included in the study. The cases were categorized according to different areas of stomach--cardia, fundus, body and antrum as per International classification of diseases 0-9 (zero-nine) codes. Time trend for each sub site was calculated using one-way ANOVA and Chi-square for trend. Of the 26,886 upper GI endoscopies done over 20 years, 1771 were found to be gastric adenocarcinomas. Gastric antrum was the most common site of cancer over the years (47.8%). There was a significant rising trend for gastric cancer of the cardia without a similar trend for the cancer of the body and antrum during the study period. The sub site-specific time trends of carcinoma stomach are not similar to the pattern seen in western countries. There is a rising trend for the cancer of the cardia with a stable trend for distal cancers over 20 years.