Thématique :
- Cancers autres (hors CCR et CHC)
Originalité :
Solidité :
Doit faire évoluer notre pratique :
Dans certains cas
Nom du veilleur :
Professeur Sylvain MANFREDI
Coup de coeur :
Journal of the National Cancer Institute (JNCI)
  2018 Jun ;110(6):608-615.  
  doi: 10.1093/jnci/djx262.  
  The Changing Face of Noncardia Gastric Cancer Incidence Among US Non-Hispanic Whites  
  Anderson WF, Rabkin CS, Turner N, Fraumeni JF Jr, Rosenberg PS, Camargo MC  



The initial step for noncardia gastric carcinogenesis is atrophic gastritis, driven by either Helicobacter pylori infection or autoimmunity. In recent decades, the prevalence rates of these two major causes declined and increased, respectively, with changes in Western lifestyles. We therefore assessed gastric cancer incidence trends for US race/ethnic groups, 1995-2013.


Age-standardized rates (ASRs) from 45 North American Association of Central Cancer Tumor Registries were summarized by estimated annual percentage change (EAPC) and 95% confidence intervals (CIs). Age period cohort models supplemented standard descriptive techniques and projected future trends.


There were 137 447 noncardia cancers in 4.4 billion person-years of observation. Among non-Hispanic whites, the ASR was 2.2 per 100 000 person-years, with an EAPC of -2.3% (95% CI = -2.0% to -2.6%). Notwithstanding this overall decline, EAPCs rose 1.3% (95% CI = 0.6% to 2.1%) for persons younger than age 50 years and fell -2.6% (95% CI = -2.4% to -2.9%) for older individuals. These converging trends manifested a birth cohort effect more pronounced among women than men, with incidence among women born in 1983 twofold (95% CI = 1.1-fold to 3.6-fold) greater than those born in 1951. Age interaction was also statistically significant among Hispanic whites, with slightly increasing vs decreasing EAPCs for younger and older individuals, respectively. Incidence declined regardless of age for other races. Current trends foreshadow expected reversals in both falling incidence and male predominance among non-Hispanic whites.


Dysbiosis of the gastric microbiome associated with modern living conditions may be increasing risk of autoimmune gastritis and consequent noncardia cancer. The changing face by age and sex of gastric cancer warrants analytical studies to identify potential causal mechanisms.


Question posée
Analyse sur près de 20 ans de l’évolution épidémiologique des adénocarcinomes gastriques aux USA.
Question posée
Malgré une diminution régulière de l’incidence il y a une augmentation des K gastriques pour les générations les plus récentes par rapport aux plus âgés, plus marquée chez les femmes que les hommes, suggérant une augmentation des cancers liés aux gastrites auto-immunes. La relation avec les modifications du style de vie et probablement du microbiote sont à suspecter.

Etude épidémiologique à partir des données de 45 registres US, sur une longue période.