Contribution of H. Pylori and Smoking to US Incidence of Gastric Adenocarcinoma: A Microsimulation Model
2013
Although gastric cancer has declined dramatically in the US, the disease remains the second leading cause of cancer mortality worldwide. This analysis estimates the contribution of risk factor trends on past and future intestinal-type non-cardia gastric adenocarcinoma (NCGA) incidence.
The authors developed a population-based microsimulation model of intestinal-type NCGA and calibrated it to U.S. epidemiologic data on precancerous lesions and cancer. The model explicitly incorporated the impact of Helicobacter pylori and smoking on disease natural history, for which birth cohort-specific trends were derived from the National Health and Nutrition Examination Survey (NHANES) and National Health Interview Survey (NHIS).
Between 1978 and 2008, the model estimated that intestinal-type NCGA incidence declined 60% from 11.0 to 4.4 per 100,000 men. The authors concluded that trends in modifiable risk factors explain a significant proportion of the decline of intestinal-type NCGA incidence in the US, and are projected to continue. Although past tobacco control efforts have hastened the decline, full benefits will take decades to be realized, and further discouragement of smoking and reduction of H. pylori should be priorities for gastric cancer control efforts.
Source:
Yeh JM, Hur C, Schrag D, Kuntz KM, Ezzati M, Stout N, Ward Z, Goldie SJ. Contribution of H. Pylori and Smoking Trends to US Incidence of Intestinal-Type Noncardia Gastric Adenocarcinoma: A Microsimulation Model. PLOS Medicine 2013; 10 (5): e1001451. https://doi.org/10.1371/journal.pmed.1001451