High incidence of adenocarcinoma arising from the right side of the gastric cardia in NW Iran

Abstract

Background: In the West, the subsite incidence of gastric cancer has changed in recent decades, with cancer of the cardia increasing in incidence and that of the more distal stomach decreasing. NW Iran has a very high incidence of upper gastrointestinal cancer and we have examined the anatomical site specific incidence in this geographical region. Method and materials: Of 33 718 patients who visited our clinic from March 2000 to Jan 2003, 3119 (9.3%) with persistent upper gastrointestinal symptoms underwent upper gastrointestinal fibreoptic endoscopy. Exact tumour site, subsite, and axial view were determined. Demographic data including age, sex, and place of residence were assessed. Using matched data from the cancer registry and endoscopic survey, age standardised rates (ASR) for all subsites were calculated. Results: Upper gastrointestinal cancer was diagnosed histologically in 499 patients (16.0%). The most frequent site was the gastric cardia (126 (25.3%)) followed by the oesophageal body (90 (18.0%)), antrum (82 (16.4%)), corpus (74 (14.8%)), distal oesophagus (57 (11.4%)), gastro-oesophageal junction (47 (9.4%)), and proximal oesophagus (22 (4.4%)). From axial views of the cardia, 51.4% and 6.8% of tumours were found to originate from the lesser and greater curve, respectively. ASR for gastric cancer were 51.2 in males and 15.4 in females. Cardia cancer with ASR of 26.4 in males and 8.6 in females was the major component of gastric cancer. Conclusion: NW Iran is a geographical region with a very high incidence of cardia cancer and with the great majority originating from the right side of the cardia. This suggests a locally acting luminal carcinogen. Studying the aetiology of this cancer in NW Iran is likely to increase our understanding of the rising incidence of this cancer throughout the Western world.

Tongue-like Barrett’s esophagus is associated with gastroesophageal reflux disease

“…Two studies [25,26] in particular have attracted our attention. It has been reported that the localization of dysplasia in BE and cardiac cancer is dominant at the 12 o'clock and 3 o'clock wall of the lower esophagus [25,26] .…”

“…It has been reported that the localization of dysplasia in BE and cardiac cancer is dominant at the 12 o'clock and 3 o'clock wall of the lower esophagus [25,26] . However, we did not detect any corroborative findings in histological examinations in this study, thus more epidemiological studies will be required to examine this issue further.…”

A Combined Proteomics and Metabolomics Profiling of Gastric Cardia Cancer Reveals Characteristic Dysregulations in Glucose Metabolism

“…GCC has become a significant cause of mortality and morbidity both in the west (3)(4)(5) and in Asia (6,7), especially in China (8). Although this cancer has become an important health problem worldwide, the its pathogenesis has not been well characterized (1).…”

Helicobacter pylori vacA d1 Genotype Predicts Risk of Gastric Adenocarcinoma and Peptic Ulcers in Northwestern Iran

“…Iran with a high incidence of GC ranks fourth in Asia, after China, Japan and Korea respectively (Fujisawa et al, 1999;Wang and Wang, 2003;Derakhshan et al, 2004;Yim et al, 2007;Alizadeh et al, 2009).…”