The sex ratio in gastric cancer and hypothetical considerations relative to aetiology

Abstract

THE constancy of the sex ratio is a remarkable feature of the epidemiology of gastric cancer. Doll (1956) noted that female death rates in 13 countries ranged from 50-67 per cent of the corresponding rates for males. Haenszel (1958) found that the sex ratios in the 119 economic subregions of the United States for showed no significant departures from the national average. In the 11 areal aggregates of England and Wales mortality of males and females was highly correlated, as was that of males with that of married women by husbands' occupations in the main occupational groups, in the period around the 1951 census (Griffith, 1963). In many different comparisons therefore males and females appear to be subject to common influences so far as gastric cancer is concerned.Data from the Inter American Investigation of Mortality (Puffer and Griffith, 1967) also showed this constancy of the sex ratio. The mean of the ratios of the age-adjusted death rate of males and females in 12 cities was 1 64 and only in one city did the ratio differ significantly from this figure. Closer study revealed, however, that the value of the ratio in the combined material of all 12 cities differed by age over the 60-year age span investigated. Variations in the sex ratio with age had also been noted by Gordon, Crittenden and Haenszel (1961) Kurihara, 1962Kurihara, , 1964Kurihara, , 1966 give deaths by age, sex and site of cancer for 25 population groups in 24 countries for the 6 years 1958-63. The deaths by 5-year age groups from 25 through 84 years of males and of females from cancer of the stomach in each population during the 6 years were aggregated.

Increased risk of gastric cancer in males affects the intestinal type of cancer and is independent of age, location of the tumour and atrophic gastritis

“…Another possibility is that their action is interrelated so that the overrepresentation of GCA among males is, for example, due to age-dependent development and progression of AG in the stomach. This alternative may be supported by observations according to which there occur changes in the male-to-female ratio (M/F) of GCA with age (Griffith, 1968), and according to which a high M/F ratio especially occurs in GCA of the intestinal type, i.e., in the tumour type which particularly is related to AG in its morphogenesis (Jiirvi & Lauren. 1951;Lauren, 1965;Sipponen et al, 1983Sipponen et al, , 1984.…”

International variation

“…Incidence in men is twice that in women, although age-specific rates in women often exceed those in men in the youngest age groups (Griffith, 1968). This may be related to differences in the frequency of different subtypes of adenocarcinomas-intestinal and diffuse (Lauren, 1965).…”

Effect of Sex Hormones on the Experimental Induction of Cancer in Rat Stomach – a Preliminary Study

“…The ratio of male to female mortality from gastric cancer has been high except in young populations (under 30 years of age [1,2]. The decreased incidence of the disease in females may be interpreted as relating to dif ferences in external factors such as living environment, kinds of food, or food con sumption [ 1 ] and also to internal factors such as sex hormones and the related physiologi cal phenomena.…”

“…The decreased incidence of the disease in females may be interpreted as relating to dif ferences in external factors such as living environment, kinds of food, or food con sumption [ 1 ] and also to internal factors such as sex hormones and the related physiologi cal phenomena. In connection with the ef fects of female sex hormones on the activity of the stomach in the sexual cycle, McDonald [5] reported that estrogens increased gastric secretion, but the secretion was reduced when progesterone increased concomitantly with ovulation, and the movement of the stomach became active with ovulation.…”

“…The incidence of human gastric carcinoma is markedly higher in males than in females [1,2] and the dominant histologic type in male patients is well-differentiated adenocar cinoma. In the young population, however, gastric carcinomas are found in females as frequently as in males.…”