S83 P9. AN EPIDEMIOLOGICAL STUDY OF GASTRIC CARCINOMA IN NORTH-EAST SCOTLAND, 1976-1985 U H Prabhu, G Kennedy and N A G Mowat Gastrointestinal Research Unit, Royal Infirmary, Foresterhill, Aberdeen, Scotland Introduction. In Japan, carcinoma of the stomach is still the most common malignancy. In Europe it is the fourth most common malignancy and it is claimed that the incidence may be falling in Norway and the USA (Ref 4,5). In North-East Scotland, our clinical impression has been that the annual incidence may not be following this downward trend. Aim. A whole community study of gastric carcinoma in North-East Scotland over a myear period (1976-1985). Patients and Methods. The North-East of Scotland (Grampian Region, Orkney and Shetland) bounded to the North and East by seas and to the West by mountains, with, its captive stable population and centralised case records, is recognised as an ideal area for epidemiological surveys (Ref 1,2,3). The whole area is served by one Pathology Department with a central computerised record system. Ascertainment of cases was from 2 main sources; the case notes of all patients recorded in the diagnostic index as having had carcinoma of stomach or oesophagus were studied; the combined Pathology Department’s recorded system yielded those with a definite histological diagnosis of carcinoma of stomach. To standardise difficulties of clazssification, it was decided that all patients with adenocarcinoma in the lower 3 or 4 ems of the oesophagus would be classified as having carcinoma of the fundus of the stomach. Care was taken that no patient was duplicated. Only those patients who have been resident in the North-East of Scotland with a definite histological or Barium meal diagnosis were included in the study. Results. Over the 10 year period a,total of 1,110 patients were diagnosed as having sma of the stomach and in no less than 91% a definite histological diagnosis was obtained. There were 693 males and 417 females with a male to female rat’.0 of 1.7:l. In contrast with studies done elsewhere, the incidence rates per 100,000 population (standardised for age and sex and based on 1981 census) show no significant rise or fall (1976-1978: 21.0/100,000, 1979-1982: 20.9/100,000; 1983-1985: 22.6/100,000). The peak age incidence in both sexes was observed in the 7th and 8th decades. As this is a retrospective study it was sometimes difficult to get firm data on personal habits and previous medical history, but an average of 42% were recorded as being smokers and only 4% as having had a previous history of gastric ulcer. Only 13% were recorded as taking alcohol. We believe that these were underestimates. In contrast to previous studies suggesting a predominance of Blood groupA, the majority of our patients (47%) belonged to Blood group 0. Only 4% of patients have had previous gastric surgery. Most of our patients had a short clinical history (82% less than 6 months) and the most common presenting symptoms were recent onset “dyspepsia” (65%) and weight loss (53%). We are at present studying the population clusters of these patients in the North-East of Scotland and also making a more detailed analysis of patients with a past history of gastric surgery. RElFERENCES - 1. 2. 3. 4. 5. Kyle, J. Gastroenterology 1971; 61: 826-33. Sinclair T.S., Mowat, N.A.G. and Brunt, P.W. Gastroenterology 1983; 85: l-l 1. Nowat, N.A.G., Needham, C.D. and Brunt, P.W. quarterly Journal of Medicine 1975; 43, No 173; 45-56 Nobrega, F.T. et al. Mayo Clinic Proceedings 1983; 58: 255-260. Viste, A. et al.3ndinavian Journal of Gastroenterology 1985; 20: 99-108.

An epidemiological study of gastric carcinoma in North-East Scotland, 1976–1985

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Page 1: An epidemiological study of gastric carcinoma in North-East Scotland, 1976–1985

S83

P9. AN EPIDEMIOLOGICAL STUDY OF GASTRIC CARCINOMA IN NORTH-EAST SCOTLAND, 1976-1985

U H Prabhu, G Kennedy and N A G Mowat

Gastrointestinal Research Unit, Royal Infirmary, Foresterhill, Aberdeen, Scotland

Introduction. In Japan, carcinoma of the stomach is still the most common malignancy. In Europe it is the fourth most common malignancy and it is claimed that the incidence may be falling in Norway and the USA (Ref 4,5). In North-East Scotland, our clinical impression has been that the annual incidence may not be following this downward trend.

Aim. A whole community study of gastric carcinoma in North-East Scotland over a myear period (1976-1985).

Patients and Methods. The North-East of Scotland (Grampian Region, Orkney and Shetland) bounded to the North and East by seas and to the West by mountains, with, its captive stable population and centralised case records, is recognised as an ideal area for epidemiological surveys (Ref 1,2,3). The whole area is served by one Pathology Department with a central computerised record system. Ascertainment of cases was from 2 main sources; the case notes of all patients recorded in the diagnostic index as having had carcinoma of stomach or oesophagus were studied; the combined Pathology Department’s recorded system yielded those with a definite histological diagnosis of carcinoma of stomach. To standardise difficulties of clazssification, it was decided that all patients with adenocarcinoma in the lower 3 or 4 ems of the oesophagus would be classified as having carcinoma of the fundus of the stomach. Care was taken that no patient was duplicated. Only those patients who have been resident in the North-East of Scotland with a definite histological or Barium meal diagnosis were included in the study.

Results. Over the 10 year period a,total of 1,110 patients were diagnosed as having sma of the stomach and in no less than 91% a definite histological diagnosis was obtained. There were 693 males and 417 females with a male to female rat’.0 of 1.7:l. In contrast with studies done elsewhere, the incidence rates per 100,000 population (standardised for age and sex and based on 1981 census) show no significant rise or fall (1976-1978: 21.0/100,000, 1979-1982: 20.9/100,000; 1983-1985: 22.6/100,000). The peak age incidence in both sexes was observed in the 7th and 8th decades.

As this is a retrospective study it was sometimes difficult to get firm data on personal habits and previous medical history, but an average of 42% were recorded as being smokers and only 4% as having had a previous history of gastric ulcer. Only 13% were recorded as taking alcohol. We believe that these were underestimates. In contrast to previous studies suggesting a predominance of Blood groupA, the majority of our patients (47%) belonged to Blood group 0. Only 4% of patients have had previous gastric surgery. Most of our patients had a short clinical history (82% less than 6 months) and the most common presenting symptoms were recent onset “dyspepsia” (65%) and weight loss (53%).

We are at present studying the population clusters of these patients in the North-East of Scotland and also making a more detailed analysis of patients with a past history of gastric surgery.

RElFERENCES -

1. 2. 3.

4. 5.

Kyle, J. Gastroenterology 1971; 61: 826-33. Sinclair T.S., Mowat, N.A.G. and Brunt, P.W. Gastroenterology 1983; 85: l-l 1. Nowat, N.A.G., Needham, C.D. and Brunt, P.W. quarterly Journal of Medicine 1975; 43, No 173; 45-56 Nobrega, F.T. et al. Mayo Clinic Proceedings 1983; 58: 255-260. Viste, A. et al.3ndinavian Journal of Gastroenterology 1985; 20: 99-108.