Atlas of Cancer Mortality -

Atlas of Cancer Mortality

Results -- Geographic Patterns for Stomach Cancer

The maps for both time periods revealed high rates among whites that stretch across the northeastern and north-central states, especially in urban areas. Rates were elevated also in parts of the Southwest but were generally low across the Southeast. The geographic patterns among blacks were less pronounced, although rates were generally higher than among whites, with clustering in parts of southern Louisiana. The elevated rates in the north-central areas appear to be related to the concentration of Scandinavian and other high-risk ethnic groups from Europe,^35,36 while the elevated rates among whites in the Southwest appear to reflect the excess risk among Hispanics. ³⁷ In high-risk areas of southern Louisiana, case-control studies have suggested protective effects of fruit and vitamin C consumption in whites and blacks, while consumption of smoked foods and home-cured meats was associated with increased risk among blacks but not whites.³⁸ Although dietary factors may influence the geographic, temporal, and racial patterns of stomach cancer, there is mounting evidence that infection with Helicobactor pylori, particularly at young ages, plays a key role in the origins and distribution of gastric cancer. ^39,40

Rates for stomach cancer have been declining for many years. ⁴¹ However, the incidence of cancers arising from the gastric cardia has increased along with esophageal adenocarcinoma, both of which appear to share risk factors. ^29,30 The location of tumors within the stomach is typically not recorded on death certificates, so that geographic variation by subsite could not be studied. The SEER incidence rates among whites for total stomach cancer during 1973–95 were highest in Hawaii and lowest in Atlanta, whereas rates for tumors of the gastric cardia were highest in Seattle and lowest in Utah (unpublished SEER data).

References

29. Blot WJ, Devesa SS, Kneller RW, Fraumeni JF Jr. Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA 1991;265:1287-9.

30. Devesa SS, Blot WJ, Fraumeni JF Jr. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 1998;83:2049-53.

35. Hoover R, Mason TJ, McKay FW, Fraumeni JF Jr. Cancer by county: new resource for etiologic clues. Science 1975;189:1005-7.

36. Moradi T, Delfino RJ, Bergstrom SR, Yu ES, Adami HO, Yuen J. Cancer risk among Scandinavian immigrants in the US and Scandinavian residents compared with US whites, 1973-89. Eur J Cancer Prev 1998;7:117-25.

37. Miller BA, Kolonel LN, Bernstein L, Young JL Jr, Swanson GM, West DW, Key CR, Liff JM, Glover CS, Alexander GA, editors. Racial/ethnic patterns of cancer in the United States 1988-1992. Bethesda, MD: National Cancer Institute; 1996. NIH Publ. No. 96-4104.

38. Correa P, Fontham E, Pickle LW, Chen V, Lin YP, Haenzsel W. Dietary determinants of gastric cancer in south Louisiana inhabitants. J Natl Cancer Inst 1985;75:645-54.

39. Parsonnet J. Helicobacter pylori in the stomach—a paradox unmasked. N Engl J Med 1996;335:278-80.

40. Sonnenberg A. The US temporal and geographic variations of diseases related to Helicobacter pylori. Am J Public Health 1993;83:1006-10.

41. Landis SH, Murray T, Bolden S, Wingo PA. Cancer statistics, 1998. CA Cancer J Clin 1998;48:6-29.

Suggested Citation

Devesa SS, Grauman DG, Blot WJ, Pennello G, Hoover RN, Fraumeni JF Jr. Atlas of cancer mortality in the United States, 1950-94. Washington, DC: US Govt Print Off; 1999 [NIH Publ No. (NIH) 99-4564].