Changing patterns of gastric cancer mortality in Spain

Impact of environmental factors on gastric cancer: A review of the scientific evidence, human prevention and adaptation

Globally, gastric cancer (GC) ranks fifth in prevalence and third in fatalities, and shows a distinct geographical distribution in morbidity and mortality. Such a spatial pattern indicates that environmental factors could be an important contributor to GC. We reviewed a total of 135 relevant peer-reviewed articles and other literature published 1936-2019 to investigate the scientific evidence concerning the effects of environmental factors on GC worldwide. Environmental factors affect GC from the aspects of water, soil, air, radiation, and geology. Risk factors identified include water type, water pollution, water hardness, soil type, soil pollution, soil element content, climate change, air pollution, radiation, altitude, latitude, topography, and lithology; and most of them have an adverse impact on GC. Furthermore, we found that their effects followed five common rules: (1) the leading environmental factors that affect GC incidence and mortality vary by region, (2) the same environmental factors may have different effects on GC in different regions, (3) some different environmental factors have similar effects on GC in essence, (4) different environmental factors often interact to have combined or synergistic effects on GC, and (5) environmental factors can affect human factors to have an impact on GC. Environmental factors have a great impact on GC. Human beings may prevent GC by controlling carcinogenic factors, screening high-risk populations and providing symptomatic and rehabilitative treatments. Furthermore, adaptation measures are recommended to reduce GC risk on private and public levels. Future studies should transcend existing empirical studies to develop causal relationship models and focus on vulnerable population analysis.

Concurrent overexpression of serum p53 mutation related with Helicobacter pylori infection

Background & Aims

In the province of Cadiz (Spain), the adjusted mortality rate for gastric cancer in the coastal town of Barbate is 10/100.000 inhabitants, whereas in the inland town of Ubrique, the rate is twice as high. The rate of Helicobacter pylori (H. pylori) infection (H. pylori antibodies) in the normal population was 54% in Ubrique, but only 32% in Barbate. In the two decades since its original discovery, p53 has found a singularly prominent place in our understanding of human gastric cancer and H. pylori cause accumulation of reactive oxygen species in the mucosa compartment. This study was designed to compare serum levels of p53 in a population characterized by high mortality due to stomach cancer and a high prevalence of H. pylori infection and another population in which mortality from this cause and the prevalence of H. pylori infection are low.

Materials and methods

319 subjects from the low mortality population and 308 from the high mortality population were studied, as were 71 patients with stomach cancer. We measured serum immunoglobulin G antibody to H. pylori and serum mutant p53 protein and ceruloplasmin.

Results

The difference between the two populations in the prevalence of H. pylori infection was significant (p < 0.001). Of the seropositive, 81% had elevated values of mutant p53, in comparison with 11% of the seronegative (p < 0.0001). Serum concentration of ceruloplasmin was significantly higher in seropositive with elevated mutant p53 protein than in seronegative with normal levels of p53 (p < 0.05).

Conclusions

There is a significant association between infection with H. pylori, elevated titers of H. pylori antibodies, and positivity for serum mutant p53 protein. Such information can significantly increase our basic knowledge in molecular pathology of gastric cancer and protection against H. pylori infection.

Dietary Habits, demographical, and socio-economical risk factors of the newly diagnosed gastric cancers in the Eastern Anatolia Region of Turkey: an endemic upper gastrointestinal cancer region

The Eastern Anatolia Region of Turkey is an endemic upper gastrointestinal (esophageal and gastric) cancer region, and the incidence of these cancers are still increasing in the region. We investigated demographic features, dietary habits, and some possible etiologic factors for this high prevalence. Special attention was given to the relationship between consumption of boiled yellow butter and the occurrence of gastric cancer. Age, sex, residential area, socio-economical status, educational status, vegetable and fruit consumption, alcohol and tobacco use, tea consumption, boiled butter usage, cooking and storage methods of the patients with gastric cancer and controls were investigated in East Anatolian Regional Erzurum State Hospital. Helicobacter pylori infection for gastric cancer risk was not studied. Fruit, yellow-green vegetables, boiled butter, and breads baked by animal manure consumptions and no refrigeration are found to be statistically significant etiologic factors for gastric carcinogenesis. Dietary habits might be risk factors for gastric carcinogenesis among East Anatolian population. Some regional differences in food processing and preparation also seem to play a role in gastric carcinogenesis.

Metabolic profile of breast cancer in a population of women in southern Spain

BACKGROUND

There are indications that mortality in breast cancer is related with dietary factors, but no study has been large enough to characterise reliably how, this risk is influenced. To establish a logistic regression equation that would predict breast cancer from factors in the endocrinological and metabolic profile, we studied endocrinological and metabolic risk factors that are modified by the diet, in a population of women with breast cancer in southern Spain.

PATIENTS AND METHODS

We carried out a simple a case-control study comparing 204 women with breast cancer (96 premenopausal and 108 postmenopausal women) and 250 healthy control subjects. The predictive variables were basal glycaemia, insulin, glycosylated haemoglobin (HbA1c), C-peptide, insulin-like growth factor-I (IGF-I), total cholesterol, triglycerides, high density lipoprotein-c (HDL-C), low density lipoprotein-c (LDL-C), selenium and Quetelet index (BMI).

RESULTS

The metabolic profile differed between pre- and postmenopausal patients, and metabolic alterations were greater in postmenopausal than in premenopausal women. The differences between healthy subjects and breast cancer patients were clearly significant.

CONCLUSIONS

Our findings have several potential practical applications in the early detection of breast cancer, especially in premenopausal women; in primary prevention; and in the development of a mathematical model of breast carcinogenesis.

Prevalence of Helicobacter pylori infection in two Spanish regions with different incidence of gastric cancer

It is a cross-sectional study, comparing the prevalence of Helicobacter pylori infection (prevalence of IgG antibodies to H. pylori) in the healthy population of Ubrique and Grazalema (mountain location, mortality from stomach cancer 20/100,000) and in Barbate, (coastal location, mortality from stomach cancer 10/100,000) in the province of Cadiz, southern Spain. The subjects were randomly selected, 163 men and 169 women, 18 years or older; 179 persons were studied in the inland, and 154 in the littoral in January 1997. Of the 332 subjects investigated, 43% were positive, a mean antibody titer of 337 IU/1 (95 % CI: 254-420), and 56% were negative, with a mean titer of 18 IU/1 (95% CI: 15-19). In the coastal population, 30% has positive titers and 54% in the mountain location. By age: 18-40 years, 30% of littoral and 41% of inland population had positive titers; 41-60 years, 35% of those living in the littoral and 58% of inland population had positive titers; > 60 years, 24% of coastal inhabitants and 62% of those living in the inland had positive titers. Living in mountain locations in the province of Cadiz involves a greater ecological risk for H. pylori infection (p < 0.05).