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      Burden of gastrointestinal cancer in Asia; an overview

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          Abstract

          The cancers in the digestive system including gastric cancer, colorectal cancer, liver cancer, esophageal cancer and pancreatic cancer are one of the most common cancers in Asia. The burden of GI cancer is increasing in Asia because of aging, growth of the population and the risk factors including smoking, obesity, changing lifestyle and high prevalence of H pylori, HBV and HCV. In most Asian countries, cancer control programs or early detection and treatment services are limited despite this increase. There are many people in the developing countries inside Asia who have no health insurance and many of them are too poor to go for screening tests, early detection or medical treatments. Therefore, it is important for the health organizations and governments in each country to recognize these groups and reduce the incidence and mortality of gastrointestinal cancers, using simple and economic screening test, vaccination and changing risk factors such as smoking, diet and lifestyle by education programs.

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          Epidemiology of gastric cancer.

          Katherine D Crew, Alfred I Neugut (2006)
          The incidence and mortality of gastric cancer have fallen dramatically in US and elsewhere over the past several decades. Nonetheless, gastric cancer remains a major public health issue as the fourth most common cancer and the second leading cause of cancer death worldwide. Demographic trends differ by tumor location and histology. While there has been a marked decline in distal, intestinal type gastric cancers, the incidence of proximal, diffuse type adenocarcinomas of the gastric cardia has been increasing, particularly in the Western countries. Incidence by tumor sub-site also varies widely based on geographic location, race, and socio-economic status. Distal gastric cancer predominates in developing countries, among blacks, and in lower socio-economic groups, whereas proximal tumors are more common in developed countries, among whites, and in higher socio-economic classes. Diverging trends in the incidence of gastric cancer by tumor location suggest that they may represent two diseases with different etiologies. The main risk factors for distal gastric cancer include Helicobacter pylori (H pylori) infection and dietary factors, whereas gastroesophageal reflux disease and obesity play important roles in the development of proximal stomach cancer. The purpose of this review is to examine the epidemiology and risk factors of gastric cancer, and to discuss strategies for primary prevention.
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            Incidence and mortality of gastric cancer in China.

            Ling Yang (2006)
            Gastric cancer is one of the most frequent cancers in the world; almost two-thirds of gastric cancer cases and deaths occur in less developed regions. In China, based on two national mortality surveys conducted in 1970s and 1990s, there is an obvious clustering of geographical distribution of gastric cancer in the country, with the high mortality being mostly located in rural areas, especially in Gansu, Henan, Hebei, Shanxi and Shaanxi Provinces in the middle-western part of China. Despite a slight increase from the 1970s to early 1990s, remarkable declines in gastric cancer mortality were noticed in almost the entire population during the last decade in China. These declines were largely due to the dramatic improvements in the social-economic environment, lifestyle, nutrition, education and health care system after economic reforms started two decades ago. Nevertheless, gastric cancer will remain a significant cancer burden currently and be one of the key issues in cancer prevention and control strategy in China. It was predicted that, in 2005, 0.3 million deaths and 0.4 million new cases from gastric cancer would rank the third most common cancer. The essential package of the prevention and control strategy for gastric cancer in China would focus on controlling Helicobacter pylori (H. pylori) infection, improving educational levels, advocating healthy diet and anti-tobacco campaign, searching for cost-effective early detection, diagnosis and treatment programs including approaches for curable management and palliative care.
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              Liver cancer: descriptive epidemiology and risk factors other than HBV and HCV infection.

              Shu-Chun Chuang, Carlo La Vecchia, Paolo Boffetta (2009)
              The incidence of liver cancer is high in all low-resource regions of the world, with the exception of Northern Africa and Western Asia. The estimated worldwide number of new cases of liver cancer in 2002 is 600,000, of which 82% are from developing countries. Given the poor survival from this disease, the estimated number of deaths is similar to that of new cases. Hepatocellular carcinoma (HCC) is the main form of liver cancer. A part from chronic infections with Hepatitis B and Hepatitis C viruses, which are the main causes of HCC, contamination of foodstuff with aflatoxins, a group of mycotoxins produced by the fungi Aspergillus flavus and Aspergillus parasiticus, is an important contributor to HCC burden in many low-income country. Alcoholic cirrhosis is an important risk factor for HCC in populations with low prevalence of HBV and HCV infection, and the association between tobacco smoking and HCC is now established. Diabetes is also related to an excess risk of HCC and the increased prevalence of overweight and obesity likely contributes to it. The second most important type of liver cancer is cholangiocarcinoma, whose main known cause is infestation with the liver flukes, Opistorchis viverrini and Clonorchis sinensis, which is frequent in some areas in South-East Asia. Angiosarcoma is a rare form of liver cancer whose occurence is linked to occupational exposure to vinyl chloride.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Gastroenterol Hepatol Bed Bench
                Journal ID (iso-abbrev): Gastroenterol Hepatol Bed Bench
                Journal ID (publisher-id): GHFBB
                Title: Gastroenterology and Hepatology From Bed to Bench
                Publisher: Shaheed Beheshti University of Medical Sciences (Tehran, Iran )
                ISSN (Print): 2008-2258
                ISSN (Electronic): 2008-4234
                Publication date (Print): Winter 2015
                Volume: 8
                Issue: 1
                Pages: 19-27
                Affiliations
                [1 ] Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                [2 ] Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
                [3 ] Department of Biostatistics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                Author notes
                Reprint or Correspondence: Mohamad Amin Pourhoseingholi, PhD. Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. E-mail: aminphg@gmail.com Reprint or Correspondence: Mohamad Amin Pourhoseingholi, PhD. Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. E-mail: aminphg@gmail.com Reprint or Correspondence: Mohamad Amin Pourhoseingholi, PhD. Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. E-mail: aminphg@gmail.com
                Article
                Publisher ID: GHFBB-8-19
                DOI: 10.22037/ghfbb.v1i1.608
                PMC ID: 4285928
                PubMed ID: 25584172
                SO-VID: 0ac2983f-1714-455e-a6f7-41ffa68ea290
                Copyright © © 2015 RIGLD, Research Institute for Gastroenterology and Liver Diseases
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 29 June 2014
                Date accepted : 18 November 2014
                Categories
                Subject: Review Article

                Keywords: gastrointestinal cancers,burden,asia
                Data availability:
                Keywords: gastrointestinal cancers, burden, asia

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