Stomach cancer represents a challenging problem in oncology. In 2001 , 21,700 people in the United States will develop gastric cancer, and 13,500 will die of this disease. Worldwide it is estimated that 798,000  cases of stomach cancer will occur, making this disease a major international cause of morbidity and mortality. As we enter a new century, it is instructive to look at the history of gastric carcinoma in the 20th century. In the United States, adenocarcinoma of the stomach was the most common cause of cancer-related deaths in 1900  and fell dramatically in the latter half of the century . The gastric cancer incidence rate of roughly 35 per 100,000 in 1930 fell to approximately 3 per 100,000 in the US in the 1970s . There has been no adequate explanation for this change. It is of interest that the fall in gastric cancer has occurred in the socalled endemic or intestinal form  of the disease that is usually associated with preexisting intestinal metaplasia. This is the form of gastric cancer seen in high-incidence countries and appears to result from a combination of achlorhydria, migration of small intestinal epithelium into the stomach resulting in intestinal metaplasia, and superinfection with Helicobacter pylori . This combination over time results in chronic gastritis with dysplastic changes and finally the development of the intestinal variant of adenocarcinoma of the stomach, the form of gastric cancer that has decreased significantly in incidence in the United States over the last 70 years.
KeywordsGastric Cancer Clin Oncol Gastric Carcinoma Advanced Gastric Cancer Intestinal Metaplasia
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- 3.Gunderson IX, Donohue JH, Burch PA (1995) Stomach. In: Abeloff MD, Armitage JO, Lichter AS, Niederhuber JE (eds) Clinical oncology. Churchill Livingstone, New York, pp 1209–1241Google Scholar
- 8.Macdonald JS, Hill MC, Roberts IM (1992) Gastric cancer: epidemiology, pathology, detection and staging. In: Ahlgren JD, Macdonald JS (eds) Gastrointestinal oncology. Lippincott, Philadelphia, pp 151–158Google Scholar
- 9.AJCC staging handbook, 5th edn (1998) Lippincott, Philadelphia, pp 71–77Google Scholar
- 12.Vezerdis MP, Wanebo HJ (1992) Gastric cancer: surgical approach. In: Ahlgren JD, Macdonald JS (eds) Gastrointestinal oncology. Lippincott, Philadelphia, pp 159–170Google Scholar
- 18.Cascinu S, Labianca R, Allesandroni P et al (1997) Intensive weekly chemotherapy for advanced gastric cancer using fluorouracil, cisplatin, epi-doxorubicin, 6S-leucovorin, glutathione, and filgrastim: a report from the Italian Group for the Study of Digestive Tract Cancer. J Clin Oncol 15: 3313–3319PubMedGoogle Scholar
- 22.Kettner E, Ridwelski K, Keilholz U et al (2001) Docetaxel and cisplatin combination chemotherapy for advanced gastric cancer: results of two phase II studies (abstract). Proc ASCO 20:165AGoogle Scholar
- 26.Wils JA, Klein HO, Wagener DJT et al (1991) Sequential high-dose methotrexate and fluorouracil combined with doxorubicin: a step ahead in the treatment of advanced gastric cancer: a trial of the European Organization for Research and Treatment of Cancer Gastrointestinal Tract Coriccance Group. J Clin Oncol 9:827PubMedGoogle Scholar
- 27.Ross P, Cunningham D, Scarffe H (1999) Results of a randomized trial comparing ECF with MCF in advanced oesophageal gastric cancer (abstract). Proc Am Soc Clin Oncol 18:272AGoogle Scholar
- 33.Saltz L, Rubin M, Hochster H et al (2001) Cetuximab (IMCC225) plus irinotecan (CPT-11) is active in CPT-11-refractory colorectal cancer that expresses epidermal growth factor receptor (abstract no. 7). Proc Am Soc Clin Oncol 20:3AGoogle Scholar
- 34.Anido J, Albanell J, Rojo F (2001) Inhibition by ZD1839 (Iressa) of epidermal growth factor and heregulin induced signaling pathways in human breast cancer cells (abstract no. 1712). Proc Am Soc Clin Oncol 20:429AGoogle Scholar