Gastric cancer in Iran: epidemiology and risk factors.

Although the global incidence of gastric cancer has been decreased dramatically in recent decades, it is the most common cancer in north and northwest Iran. The wide variation in incidence across different geographical areas and higher proportion of cardia cancer are two main characteristics of gastric cancer in Iran. Current investigations indicate that a high prevalence of H.pylori infection, high dietary intake of salt and smoking are the main environmental factors of gastric cancer in Iran. Gastroesophageal reflux disease is another contributing factor in populations with a higher incidence of gastric cardia cancer. While interventions on modifiable environmental risk factors should be considered as the main modality to reduce gastric cancer development, surveillance programmes for early detection of cancer in highly selected groups may increase overall survival rates in potential patients in this country.

[1]  Hajiani Eskandar,et al.  Clinical profile of gastric cancer in Khuzestan, southwest of Iran. , 2006, World journal of gastroenterology.

[2]  H. Matsui,et al.  Hyperosmotic stress enhances interleukin‐1β expression in Helicobacter pylori‐infected murine gastric epithelial cells in vitro , 2006, Journal of gastroenterology and hepatology.

[3]  E. Kuipers,et al.  Helicobacter pylori Eradication for the Prevention of Gastric Cancer , 2006, Helicobacter.

[4]  J. Ferlay,et al.  Cancer Incidence in Five Continents , 1970, Union Internationale Contre Le Cancer / International Union against Cancer.

[5]  R. Hunt,et al.  Meta-analysis of the relationship between cagA seropositivity and gastric cancer. , 2003, Gastroenterology.

[6]  J. Byles,et al.  Association of Helicobacter pylori infection with gastric carcinoma: a meta-analysis , 1999, American Journal of Gastroenterology.

[7]  N. Sasaki,et al.  Helicobacter pylori infection and the development of gastric cancer. , 2001, The New England journal of medicine.

[8]  E W Gunter,et al.  Prospective study of serum selenium levels and incident esophageal and gastric cancers. , 2000, Journal of the National Cancer Institute.

[9]  D. Albanes,et al.  Fruits, Vegetables, and Antioxidants and Risk of Gastric Cancer among Male Smokers , 2005, Cancer Epidemiology Biomarkers & Prevention.

[10]  Y. Yamaoka,et al.  Determination of Helicobacter pylori virulence by analysis of the cag pathogenicity island isolated from Iranian patients. , 2009, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[11]  R. Malekzadeh,et al.  Survival rate of gastric and esophageal cancers in Ardabil province, North-West of Iran. , 2008, Archives of Iranian medicine.

[12]  A. Jafarzadeh,et al.  Seroprevalence of anti-Helicobacter pylori and anti-CagA antibodies among healthy children according to age, sex, ABO blood groups and Rh status in south-east of Iran. , 2007, The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology.

[13]  A. Jemal,et al.  Global Cancer Statistics , 2011 .

[14]  K. Mohammad,et al.  Geographical spread of gastrointestinal tract cancer incidence in the Caspian Sea region of Iran: Spatial analysis of cancer registry data , 2008, BMC Cancer.

[15]  J. Paul,et al.  Oesophageal and gastric intestinal-type adenocarcinomas show the same male predominance due to a 17 year delayed development in females , 2008, Gut.

[16]  S. Nakaji,et al.  The decreasing burden of gastric cancer in Japan. , 2007, The Tohoku journal of experimental medicine.

[17]  M. Zali,et al.  Survival rates and prognosis of gastric cancer using an actuarial life-table method. , 2008, Asian Pacific journal of cancer prevention : APJCP.

[18]  A. Jafarzadeh,et al.  Specific serum immunoglobulin G to H pylori and CagA in healthy children and adults (south-east of Iran). , 2007, World journal of gastroenterology.

[19]  D. Parkin,et al.  Cancer occurrence in Iran in 2002, an international perspective. , 2005, Asian Pacific journal of cancer prevention : APJCP.

[20]  Y. Yamaoka,et al.  vacA genotypes of Helicobacter pylori in relation to cagA status and clinical outcomes in Iranian populations. , 2008, Japanese journal of infectious diseases.

[21]  R. Malekzadeh,et al.  Ecologic study of serum selenium and upper gastrointestinal cancers in Iran. , 2004, World journal of gastroenterology.

[22]  T. Tsukamoto,et al.  Synergistic upregulation of inducible nitric oxide synthase and cyclooxygenase-2 in gastric mucosa of Mongolian gerbils by a high-salt diet and Helicobacter pylori infection. , 2008, Histology and histopathology.

[23]  M. Mohagheghi,et al.  A new Helicobacter pylori vacuolating cytotoxin determinant, the intermediate region, is associated with gastric cancer. , 2007, Gastroenterology.

[24]  M. Gail,et al.  Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. , 1993, Journal of the National Cancer Institute.

[25]  Paolo Vineis,et al.  Smoking and the risk of gastric cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC) , 2003, International journal of cancer.

[26]  A. Soleimani,et al.  Peptic ulcer disease, irritable bowel syndrome and constipation in two populations in Iran. , 1995, European journal of gastroenterology & hepatology.

[27]  R. Malekzadeh,et al.  The First Population-Based Cancer Survey in Kerman Province of Iran , 2007 .

[28]  R. Malekzadeh,et al.  Cancer occurrence in Ardabil: Results of a population‐based Cancer Registry from Iran , 2003, International journal of cancer.

[29]  S. Ghaderi-sohi,et al.  Trend in incidence of gastric adenocarcinoma by tumor location from 1969–2004: a study in one referral center in Iran , 2006, Diagnostic pathology.

[30]  J. Atherton,et al.  Differences in Virulence Markers between Helicobacter pylori Strains from Iraq and Those from Iran: Potential Importance of Regional Differences in H. pylori-Associated Disease , 2008, Journal of Clinical Microbiology.

[31]  S. Tsugane,et al.  Prospective study of three major dietary patterns and risk of gastric cancer in Japan , 2004, International journal of cancer.

[32]  S. Leeder,et al.  A population based study , 1993, The Medical journal of Australia.

[33]  K. Haruma,et al.  Reduction in gastric cancer mortality by screening based on serum pepsinogen concentration: A case-control study , 2007, Scandinavian journal of gastroenterology.

[34]  R. Hunt,et al.  The Association Between Helicobacter pylori Infection and Early Gastric Cancer: A Meta-Analysis , 2007, The American Journal of Gastroenterology.

[35]  I. Bergin,et al.  Helicobacter pylori Infection and High Dietary Salt Independently Induce Atrophic Gastritis and Intestinal Metaplasia in Commercially Available Outbred Mongolian Gerbils , 2003, Digestive Diseases and Sciences.

[36]  M. Malek,et al.  Cancer occurrence in Semnan Province, Iran: results of a population-based cancer registry. , 2005, Asian Pacific journal of cancer prevention : APJCP.

[37]  M. Rayman.  Selenium in cancer prevention: a review of the evidence and mechanism of action , 2005, Proceedings of the Nutrition Society.

[38]  R. Malekzadeh,et al.  High incidence of adenocarcinoma arising from the right side of the gastric cardia in NW Iran , 2004, Gut.

[39]  Khean Lee Goh,et al.  Screening for gastric cancer in Asia: current evidence and practice. , 2008, The Lancet. Oncology.

[40]  M. Mohagheghi,et al.  cagA Gene and Protein Status Among Iranian Helicobacter pylori Strains , 2008, Digestive Diseases and Sciences.

[41]  R. Hunt,et al.  Meta-analysis of the relationship between Helicobacter pylori seropositivity and gastric cancer. , 1998, Gastroenterology.

[42]  S. Tannenbaum,et al.  A MODEL FOR GASTRIC CANCER EPIDEMIOLOGY , 1975, The Lancet.

[43]  D. Forman,et al.  An international association between Helicobacter pylori infection and gastric cancer , 1993 .

[44]  R. Malekzadeh,et al.  Combination of gastric atrophy, reflux symptoms and histological subtype indicates two distinct aetiologies of gastric cardia cancer , 2007, Gut.

[45]  Mario Plebani,et al.  Meat intake and risk of stomach and esophageal adenocarcinoma within the European Prospective Investigation Into Cancer and Nutrition (EPIC). , 2006, Journal of the National Cancer Institute.

[46]  Elio Riboli,et al.  Epidemiologic evidence of the protective effect of fruit and vegetables on cancer risk. , 2003, The American journal of clinical nutrition.

[47]  R. Hunt,et al.  Asia–Pacific consensus guidelines on gastric cancer prevention , 2008, Journal of gastroenterology and hepatology.

[48]  R. Malekzadeh,et al.  Epidemiology of upper gastrointestinal cancers in Iran: a sub site analysis of 761 cases. , 2007, World journal of gastroenterology.

[49]  E. Kuipers,et al.  Review article: Helicobacter pylori eradication for the prevention of gastric cancer , 2007, Alimentary pharmacology & therapeutics.

[50]  C. Abnet,et al.  Prospective study of serum selenium concentrations and esophageal and gastric cardia cancer, heart disease, stroke, and total death. , 2004, The American journal of clinical nutrition.

[51]  Z. Fan,et al.  Association of methylenetetrahydrofolate reductase and thymidylate synthase promoter polymorphisms with genetic susceptibility to esophageal and cardia cancer in a Chinese high-risk population. , 2005, Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus.

[52]  K. Arii,et al.  Serum pepsinogen and gastric cancer screening. , 2007, Internal medicine.

[53]  R. Malekzadeh,et al.  Childhood Hygienic Practice and Family Education Status Determine the Prevalence of Helicobacter pylori Infection in Iran , 2009, Helicobacter.

[54]  A. Wolk,et al.  Total antioxidant potential of fruit and vegetables and risk of gastric cancer. , 2002, Gastroenterology.

[55]  R. Peto,et al.  Serum selenium and subsequent risk of cancer among Finnish men and women. , 1990, Journal of the National Cancer Institute.

[56]  T. Wang,et al.  High-salt diet induces gastric epithelial hyperplasia and parietal cell loss, and enhances Helicobacter pylori colonization in C57BL/6 mice. , 1999, Cancer research.

[57]  J. Raafat,et al.  Gastric carcinoma: 5 year experience of a single institute. , 2005, Asian Pacific journal of cancer prevention : APJCP.

[58]  R. Malekzadeh,et al.  Critical role of Helicobacter pylori in the pattern of gastritis and carditis in residents of an area with high prevalence of gastric cardia cancer , 2007, Digestive Diseases and Sciences.

[59]  R. Malekzadeh,et al.  Prevalence of gastric precancerous lesions in Ardabil, a high incidence province for gastric adenocarcinoma in the northwest of Iran , 2003, Journal of clinical pathology.

[60]  R. Malekzadeh,et al.  The role of diet and other environmental factors in the causation of gastric cancer in Iran—A population based study , 2009, International journal of cancer.

[61]  Shoichiro Tsugane,et al.  Salt, salted food intake, and risk of gastric cancer: Epidemiologic evidence , 2005, Cancer science.

[62]  R. Kelishadi,et al.  A province-based surveillance system for the risk factors of non-communicable diseases: A prototype for integration of risk factor surveillance into primary healthcare systems of developing countries. , 2009, Public health.

[63]  A. Alborzi,et al.  Prevalence of Helicobacter pylori infection in children (south of Iran). , 2006, Diagnostic microbiology and infectious disease.

[64]  Reza Ghadimi,et al.  Host and environmental factors for gastric cancer in Babol, the Caspian Sea Coast, Iran , 2007, European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation.

[65]  M. Mohagheghi,et al.  dupA as a risk determinant in Helicobacter pylori infection. , 2008, Journal of medical microbiology.

[66]  L. Vatten,et al.  Smoking and alcohol drinking in relation to risk of gastric cancer: A population‐based, prospective cohort study , 2007, International journal of cancer.

[67]  S. Bingham,et al.  Effect of white versus red meat on endogenous N-nitrosation in the human colon and further evidence of a dose response. , 2002, The Journal of nutrition.

[68]  M. Gail,et al.  Total and cancer mortality after supplementation with vitamins and minerals: follow-up of the Linxian General Population Nutrition Intervention Trial. , 2009, Journal of the National Cancer Institute.

[69]  R. Malekzadeh,et al.  Cancer incidence in Tehran metropolis: the first report from the Tehran Population-based Cancer Registry, 1998-2001. , 2009, Archives of Iranian medicine.

[70]  J. Fraumeni,et al.  Red meat, family history, and increased risk of gastric cancer with microsatellite instability. , 2001, Cancer research.

[71]  E. Lesaffre,et al.  Dietary salt, nitrate and stomach cancer mortality in 24 countries. European Cancer Prevention (ECP) and the INTERSALT Cooperative Research Group. , 1996, International journal of epidemiology.

[72]  G. Nardone,et al.  Is Screening for and Surveillance of Atrophic Gastritis Advisable? , 2007, Digestive Diseases.

[73]  M. Gail,et al.  Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions. , 2006, Journal of the National Cancer Institute.

[74]  Anthony E. Reeve,et al.  E-cadherin germline mutations in familial gastric cancer , 1998, Nature.

[75]  J. Ferlay,et al.  Global Cancer Statistics, 2002 , 2005, CA: a cancer journal for clinicians.

[76]  R. Malekzadeh,et al.  Declining incidence of esophageal cancer in the Turkmen Plain, eastern part of the Caspian Littoral of Iran: a retrospective cancer surveillance. , 2006, Cancer detection and prevention.

[77]  S. Farhang,et al.  Cancer in East Azerbaijan, Iran: results of a population-based cancer registry. , 2008, Asian Pacific journal of cancer prevention : APJCP.

[78]  M. Zali,et al.  Seroprevalence of Helicobacter pylori in Nahavand: a population-based study. , 2009, Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit.