Year 2024 / Volume 116 / Number 1
Original
Age, period and cohort effects on gastric cancer mortality in Spain, 1980-2021

22-28

DOI: 10.17235/reed.2023.9668/2023

Lucía Cayuela, Álvaro Giráldez Gallego, Marta Garzón Benavides, José Manuel Sousa Martín, Aurelio Cayuela,

Abstract
Background: this study aimed to evaluate the effects of age, time period and cohort (A-P-C) on gastric cancer (GC) mortality in Spain from 1980 to 2021. Methods: an ecological trend study was performed (with aggregated data obtained from the Spanish National Statistics Institute (INE). Joinpoint regression software was used to estimate rates by sex and age group (< 35, 35-64, > 64 years) and mortality trends. The National Cancer Institute A-P-C tools were used to assess the effects of age, time of death and birth cohort. Results: GC mortality rates in Spain decreased significantly in both sexes. In the under-35 age group, rates were stable after an initial significant decline. In the 35-64 age group, the decline was more pronounced in males than in females. In the 65+ age group, rates fell significantly for both sexes, but more so for females than for males. The net drift and local drift also showed significant decreases across all age groups from 24 years onwards. GC mortality rates increased with age and decreased with calendar time and successive birth cohorts, regardless of sex. The ratio of age-specific rates between males and females increased with age, and birth cohort relative risk estimates followed a steady downward trend until the mid-1970s, after which the decline stabilized. The relative risk decreased for both sexes, with a more pronounced decrease in males. Conclusion: GC mortality rates in Spain have been decreasing over time and across successive birth cohorts, with a stabilizing trend observed for those under 35 years of age.
Lay Summary
This study aimed to examine how different factors such as age, period, and cohort (A-P-C) affect mortality from gastric cancer (GC) in Spain over a 41-year period from 1980 to 2021. The study analyzed aggregated data obtained from the National Institute of Statistics, and used statistical methods such as joinpoint regression software and National Cancer Institute A-P-C tools to estimate mortality rates and trends by sex and age group. The study found that overall GC mortality rates decreased significantly for both sexes in Spain during the study period. However, there were some variations in the trends by age group and sex. In the under-35 age group, rates were stable after an initial significant decline. In the 35-64 age group, the decline was more pronounced in men than in women. In the 65+ age group, rates fell significantly for both sexes, but more so for women than for men. The study also found that GC mortality rates increased with age, and decreased with calendar time and successive birth cohorts, regardless of sex. The ratio of age-specific rates between men and women increased with age, and birth cohort relative risk estimates followed a steady downward trend until the mid-1970s, after which the decline stabilized. The relative risk decreased for both sexes, with a more pronounced decrease in men. Overall, the study provides important insights into the trends and factors that affect mortality from GC in Spain. The findings suggest that efforts to reduce GC mortality should focus on early detection and prevention strategies, particularly for those at higher risk due to age and sex.
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References
1. Torres-Roman JS, Alvarez CS, Guerra-Canchari P, et al. Sex and age differences in mortality trends of gastric cancer among Hispanic/Latino populations in the United States, Latin America, and the Caribbean. Lancet regional health Americas. 2022;16. doi:10.1016/J.LANA.2022.100376
2. Luo G, Zhang Y, Guo P, Wang L, Huang Y, Li K. Global patterns and trends in stomach cancer incidence: Age, period and birth cohort analysis. Int J Cancer. 2017;141(7):1333-1344. doi:10.1002/IJC.30835
3. Collatuzzo G, Santucci C, Malvezzi M, La Vecchia C, Boffetta P, Negri E. Trends in gastric cancer mortality 1990-2019 in 36 countries worldwide, with predictions to 2025, and incidence, overall and by subtype. Cancer Med. Published online 2023. doi:10.1002/CAM4.5685
4. Tarupi W, De Vries E, Cueva P, Yépez J. Stagnation in Decreasing Gastric Cancer Incidence and Mortality in Quito: Time Trend Analysis, 1985-2013. J Cancer Epidemiol. 2019;2019. doi:10.1155/2019/1504894
5. Wong MCS, Huang J, Chan PSF, et al. Global Incidence and Mortality of Gastric Cancer, 1980-2018. JAMA Netw Open. 2021;4(7):2118457. doi:10.1001/JAMANETWORKOPEN.2021.18457
6. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-249. doi:10.3322/CAAC.21660
7. Seoane-Mato D, Aragonés N, Ferreras E, et al. Trends in oral cavity, pharyngeal, oesophageal and gastric cancer mortality rates in Spain, 1952-2006: an age-period-cohort analysis. BMC Cancer. 2014;14(1). doi:10.1186/1471-2407-14-254
8. Aragonés N, Goicoa T, Pollán M, et al. Spatio-temporal trends in gastric cancer mortality in Spain: 1975-2008. Cancer Epidemiol. 2013;37(4):360-369. doi:10.1016/J.CANEP.2013.03.009
9. García-Esquinas E, Pérez-Gómez B, Pollán M, et al. Gastric cancer mortality trends in Spain, 1976-2005, differences by autonomous region and sex. BMC Cancer. 2009;9:346. doi:10.1186/1471-2407-9-346
10. Malvezzi M, Bonifazi M, Bertuccio P, et al. An age-period-cohort analysis of gastric cancer mortality from 1950 to 2007 in Europe. Ann Epidemiol. 2010;20(12):898-905. doi:10.1016/J.ANNEPIDEM.2010.08.013
11. 2013 edition Revision of the European Standard Population Report of Eurostat’s task force. doi:10.2785/11470
12. Download Joinpoint Desktop Software. Accessed February 17, 2023. https://surveillance.cancer.gov/joinpoint/download
13. Setting The Joinpoint Parameters — Joinpoint Help System. Accessed March 2, 2023. https://surveillance.cancer.gov/help/joinpoint/setting-parameters
14. Parallel Pairwise Comparison and Number of Joinpoints — Joinpoint Help System. Accessed March 17, 2023. https://surveillance.cancer.gov/help/joinpoint/tech-help/frequently-asked-questions/pairwise-comparison-and-number-of-joinpoints
15. Rosenberg PS, Check DP, Anderson WF. A web tool for age-period-cohort analysis of cancer incidence and mortality rates. Cancer Epidemiol Biomarkers Prev. 2014;23(11):2296-2302. doi:10.1158/1055-9965.EPI-14-0300
16. Lyons K, Le LC, Pham YTH, et al. Gastric cancer: epidemiology, biology, and prevention: a mini review. Eur J Cancer Prev. 2019;28(5):397-412. doi:10.1097/CEJ.0000000000000480
17. Collatuzzo G, Pelucchi C, Negri E, et al. Exploring the interactions between Helicobacter pylori (Hp) infection and other risk factors of gastric cancer: A pooled analysis in the Stomach cancer Pooling (StoP) Project. Int J Cancer. 2021;149(6):1228-1238. doi:10.1002/IJC.33678
18. Arnold M, Park JY, Camargo MC, Lunet N, Forman D, Soerjomataram I. Is gastric cancer becoming a rare disease? A global assessment of predicted incidence trends to 2035. Gut. 2020;69(5):823-829. doi:10.1136/GUTJNL-2019-320234
19. Machlowska J, Baj J, Sitarz M, Maciejewski R, Sitarz R. Gastric Cancer: Epidemiology, Risk Factors, Classification, Genomic Characteristics and Treatment Strategies. Int J Mol Sci. 2020;21(11). doi:10.3390/IJMS21114012
20. Torres-Roman JS, Alvarez CS, Guerra-Canchari P, et al. Sex and age differences in mortality trends of gastric cancer among Hispanic/Latino populations in the United States, Latin America, and the Caribbean. The Lancet Regional Health - Americas. 2022;16:100376. doi:10.1016/J.LANA.2022.100376
21. Chen M, Chen K, Hou H, et al. Incidence and mortality trends in gastric cancer in the United States, 1992-2019. Int J Cancer. 2023;152(9). doi:10.1002/IJC.34415
22. Anderson WF, Rabkin CS, Turner N, Fraumeni JF, Rosenberg PS, Camargo MC. The Changing Face of Noncardia Gastric Cancer Incidence Among US Non-Hispanic Whites. JNCI: Journal of the National Cancer Institute. 2018;110(6):608-615. doi:10.1093/JNCI/DJX262
23. Yan S, Gan Y, Song X, et al. Association between refrigerator use and the risk of gastric cancer: A systematic review and meta-analysis of observational studies. PLoS One. 2018;13(8). doi:10.1371/JOURNAL.PONE.0203120
24. Álvarez-álvarez L, Vitelli-Storelli F, Rubín-García M, et al. Relationship between the Risk of Gastric Cancer and Adherence to the Mediterranean Diet According to Different Estimators. MCC-Spain Study. Cancers (Basel). 2021;13(21). doi:10.3390/CANCERS13215281
25. Boldo E, Fernández de Larrea N, Pollán M, et al. Meat Intake, Cooking Methods, Doneness Preferences and Risk of Gastric Adenocarcinoma in the MCC-Spain Study. Nutrients. 2022;14(22). doi:10.3390/NU14224852
26. Rota M, Alicandro G, Pelucchi C, et al. Education and gastric cancer risk-An individual participant data meta-analysis in the StoP project consortium. Int J Cancer. 2020;146(3):671-681. doi:10.1002/IJC.32298
27. Aragonés N, Pérez-Gómez B, Pollán M, et al. The striking geographical pattern of gastric cancer mortality in Spain: environmental hypotheses revisited. BMC Cancer. 2009;9:316. doi:10.1186/1471-2407-9-316
28. Shah SC, Boffetta P, Johnson KC, et al. Occupational exposures and odds of gastric cancer: a StoP project consortium pooled analysis. Int J Epidemiol. 2020;49(2):422-434. doi:10.1093/IJE/DYZ263
29. Praud D, Rota M, Pelucchi C, et al. Cigarette smoking and gastric cancer in the Stomach Cancer Pooling (StoP) Project. Eur J Cancer Prev. 2018;27(2):124-133. doi:10.1097/CEJ.0000000000000290
30. Seoane-Mato D, Nuñez O, Fernández-de-Larrea N, et al. Long-term trends in pancreatic cancer mortality in Spain (1952-2012). BMC Cancer. 2018;18(1). doi:10.1186/s12885-018-4494-3
31. Wang C, Weber A, Graham DY. Age, period, and cohort effects on gastric cancer mortality. Dig Dis Sci. 2015;60(2):514-523. doi:10.1007/S10620-014-3359-0
32. Glasser JH. The quality and utility of death certificate data. Am J Public Health. 1981;71(3):231-233. doi:10.2105/AJPH.71.3.231
33. Pérez-Gómez B, Aragonés N, Pollán M, et al. Accuracy of cancer death certificates in Spain: a summary of available information. Gac Sanit. 2006;20 Suppl 3(SUPPL. 3):42-51. doi:10.1157/13101089
34. Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391(10125):1023-1075. doi:10.1016/S0140-6736(17)33326-3
35. Schwartz S. The fallacy of the ecological fallacy: The potential misuse of a concept and the consequences. Am J Public Health. 1994;84(5):819-824. doi:10.2105/AJPH.84.5.819
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Cayuela L, Giráldez Gallego Á, Garzón Benavides M, Sousa Martín J, Cayuela A. Age, period and cohort effects on gastric cancer mortality in Spain, 1980-2021. 9668/2023


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Publication history

Received: 15/04/2023

Accepted: 27/07/2023

Online First: 04/08/2023

Published: 11/01/2024

Article revision time: 99 days

Article Online First time: 111 days

Article editing time: 271 days


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