EARLY GASTRIC-CANCER - RESULTS OF A 20-YE AR POPULATION-BASED SURVEY

Objectives. - The aim of this study was to analyse the incidence, trea tment and prognosis of early gastric cancer in a population-based seri es and to draw a picture of time trends. Methods. - Over a 20-year per iod (1976-1995), 80 early gastric cancers were diagnosed-in the Cote-d 'Or area (493,000 residents). Incidence rates were calculated by sex, age groups and 5-year periods. Prognostic factors were determined usin g the Kaplan-Meier method and the Cox model. Results. - Age-standardiz ed incidence rates were 0.8/100,000 in men and 0.3/100,000 in women. I ncidence increased slightly over time NS) and their proportion among g astric cancers increased from 3.4% (1976-1980) to 7.9% (1991-1995) (P < 0.01). Among these cancers, 25 were intramucosal (31.3 %), 55 were s ubmucosal (68.8 %) and 8 had lymph node metastases (10.0 %). Overall, 21 patients (24.1 %) had already been treated for a peptic ulcer The 5 -year crude survival rate was 63.1% and the corresponding net survival rate was 86.3%. Lymph node metastases, location, sex and cancer exten sion and age were independent prognostic factors. Conclusions. - Thoug h it is on the increase, the proportion of early gastric cancers remai ns low among gastric cancers. This study confirms the importance of pe rforming a gastroscopy with biopsy upon each bout of ulcer and that th e prognosis is lower than suggested by hospital based series.