Stomach cancer - UK incidence statistics

Stomach cancer is the ninth most common cancer in males in the UK and fourteenth in females. There were 7,610 new cases of stomach cancer diagnosed in 2008 (Table 1.1). 1-4 The male:female ratio is around 1.8:1. It has been estimated that the lifetime risk of developing stomach cancer in 2008 was around 1 in 60 for men and around 1 in 120 for women in the UK. This was done using the AMP method.5

Table 1.1: Stomach Cancer (C16), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2008

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*95% LCL and 95% UCL are the 95% lower and upper confidence limits around the AS Rate

Figure 1.1 shows the age-specific cases and rates for stomach cancer in the UK. 1-4 Stomach cancer occurs mainly in older people. Around 8% of cases are diagnosed before the age of 55 years and the rates increase steeply from age 60 onward reaching a rate of around 140 per 100,000 population in men aged 85 and over and around 67 per 100,000 in women aged 85 and over.

Figure 1.1: Stomach Cancer (C16), Average Number of New Cases per Year and Age-Specific Incidence Rates, UK, 2006-2008

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Most stomach cancers (around 95%) are adenocarcinomas which may be further classified into 'intestinal' and 'diffuse' type.

'Intestinal' adenocarcinomas are associated with a history of atrophic gastritis, have better survival and are associated with older patients, whereas the 'diffuse' adenocarcinomas are more common, with poorer survival and occur more frequently in women and people with blood group 'A'. 6

Other stomach malignant histologies include lymphomas and leiomyosarcomas.

In Britain the age-standardised incidence rates for males have more than halved from 30 per 100,000 in 1975-1977 to 13 per 100,000 in 2006-2008. The trend is similar for females but with rates falling from around 14 per 100,000 to around 5 per 100,000 over the same period. (Figure 1.2). 1-3

Figure 1.2: Stomach Cancer (C16), European Age-Standardised Incidence Rates, Great Britain, 1975-2008

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The incidence trend for stomach cancer the UK is shown in Figure 1.3. 1-4

Figure 1.3: Stomach Cancer (C16), European Age-Standardised Incidence Rates, UK, 1993-2008

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In 2008 there were estimated to be around 83,000 new cases of stomach cancer diagnosed in the European Union (EU27).7 Within the EU27 there is approximately a fourfold difference in incidence across countries. The highest incidence rates were in Lithuania for males and in Estonia for females. The lowest stomach cancer incidence rates in the EU27 were in Sweden. Rates for the UK were below the EU27 average (Figure 1.4). 8

Figure 1.4: Stomach Cancer (C16), European Age-Standardised Incidence Rates,    EU-27 Countries, 2008 Estimates

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There were estimated to be 988,000 cases of stomach cancer diagnosed worldwide in 2008. International incidence rates of stomach cancer vary widely. The highest rates of stomach cancer in the world occur in Eastern Asia (China, Japan, Republic of Korea, Democratic Republic of Korea and Mongolia) where the rate is 42 per 100,000 males and 18 per 100,000 females (Figure 1.5). High rates also occur in Eastern Europe and South America - these are all above the world average of 20 and 9 per 100,000 males and females respectively. The lowest international incidence rates occur in Northern and Southern Africa. 7

Figure 1.5: Stomach Cancer (C16), World Age-Standardised Incidence Rates, World Regions, 2008 Estimates

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Incidence and mortality from stomach cancer are strongly related to social class and measures of deprivation, with higher rates in socially and economically deprived groups. 9

Using Carstairs deprivation scores (a score of material deprivation derived from four census variables - car ownership, household overcrowding, head of household in social class IV or V and male unemployment), the incidence and mortality rates in England and Wales are about twice as high in the most deprived groups compared to the least deprived. 10  Recent data for England for 2000-2004 show this relationship persists, with the most deprived having European age-standardised rates of 14.6 per 100,000 compared with 8.0 for the least deprived.11

A strong association with social deprivation is also reported for Scotland (Figure 1.6).12

*The rates in Figure 1.6 are standardised to the European population

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Despite an overall decline in incidence rates of stomach cancer, several countries, including those in the UK, 13-14 have seen an increase in the incidence of adenocarcinomas of the gastric cardia, which is the region of the stomach that joins the lower oesophagus, sometimes referred to as proximal gastric cancer.

The rising rates of cancer in the gastric cardia in contrast to the falling rates elsewhere in the stomach are illustrated in Figure 1.7 using England data.

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As the incidence of adenocarcinoma of the lower oesophagus is also increasing it has been suggested that tumours in the region of the gastro-oesophageal junction (GOJ) may share similar risk factors and should be treated as a separate entity. 14-15 Tumours of the lower oesophagus are particularly associated with a condition called Barrett’s oesophagus that may develop as a result of gastric reflux (see Oesophageal cancer.).

Prevalence data relates to the people in the UK population alive on a specific date having previously been diagnosed with cancer. The latest analysis shows that on 31st December 2006, around 13,300 people were alive up to ten years after being diagnosed with stomach cancer. 17 Table 1.2 shows the one, five and ten year prevalence by sex for stomach cancer.

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