Changing incidence of gastric and oesophageal cancer subtypes in central Switzerland between 1982 and 2007

Several Western countries have reported a decrease in the incidence of noncardia gastric adenocarcinoma and a strong increase in the incidence of oesophageal and cardia adenocarcinoma. We examined incidence rates of gastric and oesophageal cancer by subsite and histology in Central Switzerland over the last 26 years. Data on biopsy-diagnosed gastric and oesophageal carcinoma incidence during 1982-2007 were obtained from the Cancer Registry of the Institute of Pathology, Lucerne, the Medical Centre for Central Switzerland. Age-adjusted (standardized to the European standard population), and sex-specific incidence rates were calculated. In total, 2,322 cancers were diagnosed: 1,240 noncardia gastric adenocarcinomas, 459 cardia gastric adenocarcinomas, 248 oesophageal adenocarcinomas, and 375 squamous cell carcinomas. From 1982 to 2007, the incidence rates of noncardia adenocarcinoma decreased substantially from 17.9 (per 100,000) to 6.0 in men and 10.3 to 5.5 in women. In men, the incidence of gastric cardia adenocarcinoma decreased from 7.5 to 4.3, the incidence of oesophageal adenocarcinoma increased from 3.3 to 4.8, and the incidence of oesophageal squamous cell carcinoma decreased from 6.6 to 4.1; the incidence rates of these cancers were low in women (1.1-2.4). In conclusion, the incidence of gastric noncardia carcinoma has decreased substantially over the past 26 years. In contrast to other Western countries, the incidence of gastric cardia adenocarcinoma did not increase in Central Switzerland. Whereas the rate of oesophageal adenocarcinoma increased, the rate of squamous cell carcinoma decreased. These results suggest substantial changes in environmental and life-style risk factors over the past 26 years.