Stomach cancer incidence trends in selected Latin America countries: Age,period, and birth-cohort effects |
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| Institution: | 1. National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;2. Health Technology Management Coordination, National Health Agency, Rio de Janeiro, Brazil;3. Department of Epidemiology and Quantitative Methods, National Public Health School, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;1. Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN, USA;2. Department of Environmental and Occupational Health, School of Public Health, Indiana University, Bloomington, IN, USA;3. Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA;4. Department of Translational Sciences Section, School of Nursing, University of California, Los Angeles, CA, USA;5. Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, NY, USA;6. Department of Medical Oncology, The Lundquist Institute, Torrance, CA, USA;7. Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA;8. Division of Epidemiology, Vanderbilt University Medical Center, Vanderbilt University, Nashville, TN, USA;1. Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA;2. Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA;3. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA;1. Department of Epidemiology, Radiation Effects Research Foundation, 5-2, Hijiyama Park, Minami-ku, Hiroshima City, Hiroshima 732-0815, Japan;2. Division of International Health Policy Research, Institution for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;3. Research Department, Fondazione IRCSS, Istituto Nazionale dei Tumouri, Via Venezian 1, 20133, Milan, Italy;1. Department of Internal Medicine, Jackson Memorial Hospital / University of Miami Health System, FL, USA;2. The Population Registry of Cancer of the Metropolitan Area of Bucaramanga, Universidad Autónoma de Bucaramanga, Colombia;3. Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia;4. University of Miami Miller School of Medicine and Sylvester Comprehensive Cancer Center, FL, USA;1. Faculty of Pharmacy, Universidade Federal de Minas Gerais, Brazil;2. Ezequiel Dias Foundation, Brazil;3. Hospital das Clínicas, Universidade Federal de Minas Gerais, Brazil;1. Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA;2. Division of Oncology, Center for Childhood Cancer Research, Children’s Hospital of Philadelphia, PA, USA;3. Department of Genetics, University of Pennsylvania, Philadelphia, PA, USA;4. Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA |
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| Abstract: | Backgroundto explore the age, period, and birth-cohort effects on stomach cancer incidence trends during 3 decades in selected Latin American countries.Methodsa time-trend study was performed using Cancer Incidence in Five Continents data from high-quality population-based cancer registries(PBCRs) in Latin American countries. Crude and age-standardized incidence rates(ASRIs) were calculated. Time trends in ASRIs were assessed using the average annual percentage change(AAPC). Age-period-cohort effects were estimated by Poisson regression for individuals aged between 20 and 79 years with stomach cancer informed by PBCRs from 1983 to 2012 in Cali(Colombia); from 1982 to 2011 in Costa Rica; and from 1988 to 2012 for Goiania(Brazil) and Quito(Ecuador). The goodness-of-fit model was tested using the deviance of the models.Resultsa decrease in age-standardized incidence rates was observed for both genders in all populations covered by PBCRs, except for young men from Cali(AAPC 3.89 95 %IC: 1.32–7.29). The age effect was statistically significant in all areas, and the curve slope reached peaks in the older age groups. The cohort effect was observed in all PBCRs. Regarding the period effect, an increased ratio rate was observed for both genders in Costa Rica(1997–2001 women RR 1.11 95 %CI: 1.05–1.17; men RR 1.12 95 %CI: 1.08–1.17) and Goiânia(2003–2007 women RR 1.21 95 %CI: 1.08–1.35; men RR 1.09 95 %CI: 1.01–1.20), while Quito(1998–2002 women RR 0.89 95 %CI: 0.81–0.98; men RR 0.86 95 %CI: 0.79–0.93) presented a decrease.Conclusionthe present study showed a decreasing gastric cancer trend for over the past 30 years with gender and geographic variations. Such a decrease seems to be mainly a result of cohort effects, suggesting that the economic market opening process led to changes in the risk factor exposures over successive generations. These geographic and gender variations may reflect cultural/ethnic/gender differences and differences in dietary and smoking rate patterns. However, an increased incidence was observed for young men in Cali, and additional studies are needed to determine the cause of the increasing incidence in this group. |
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| Keywords: | Stomach neoplasms Age effect Period effect Cohort effect APC analysis |
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