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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1997 Aug;51(4):412–417. doi: 10.1136/jech.51.4.412

Time trend and age-period-cohort effects on gastric cancer incidence in Zaragoza and Navarre, Spain.

N Aragonés 1, M Pollán 1, G López-Abente 1, M Ruiz 1, A Vergara 1, C Moreno 1, P Moreo 1, E Ardanaz 1
PMCID: PMC1060511  PMID: 9328549

Abstract

STUDY OBJECTIVE: To describe time trends in gastric cancer incidence in Zaragoza and Navarre, and to investigate time period and birth cohort as determinants of such trends. DESIGN: Cases from two registries were grouped into five year intervals and the following were calculated: age specific and sex specific incidence rates, and the male to female ratio. Log linear models including age, period of diagnosis, and birth cohort were fitted. SETTING: The Zaragoza Cancer Registry covers the province of Zaragoza, which has a population of 824,776 (403,755 men and 421,021 women). The Navarre Cancer Registry covers the province of Navarre which has 512,512 inhabitants (254,786 men and 257,726 women). In both cases population figures were based on the late census. PATIENTS: These comprised incident cases of gastric cancer reported to the Zaragoza Cancer Registry in 1963-87 and to the Navarre Cancer Registry in 1973-87. MAIN RESULTS: Navarre registered higher adjusted and cumulative rates than Zaragoza for both sexes. In both provinces, there were relative declines in the rates for men and women of 3% and 4% respectively per year. In Zaragoza, the risk of developing stomach cancer fell in generations born between 1888 and 1933, and rose in subsequent birth cohorts in both sexes, while in Navarre the cohort effect showed an approximately linear risk for both sexes. Both provinces recorded increases in risk associated with cohorts born between 1933 and 1943. CONCLUSION: The incidence rates of gastric cancer fell in both Zaragoza and Navarre. The reason for the greater incidence of gastric cancer in Navarre remains unknown. Trends in rates seem to be mainly linked to birth cohort. Increases in risk in generations born after 1933 may be ascribable to nutritional deficiencies in the early years of life.

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Selected References

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  1. Blot W. J., Devesa S. S., Kneller R. W., Fraumeni J. F., Jr Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA. 1991 Mar 13;265(10):1287–1289. [PubMed] [Google Scholar]
  2. Bolumar F., Vioque J., Cayuela A. Changing mortality patterns for major cancers in Spain, 1951-1985. Int J Epidemiol. 1991 Mar;20(1):20–25. doi: 10.1093/ije/20.1.20. [DOI] [PubMed] [Google Scholar]
  3. Capocaccia R., De Angelis R., Frova L., Sant M., Buiatti E., Gatta G., Micheli A., Berrino F., Barchielli A., Conti E. Estimation and projections of stomach cancer trends in Italy. Cancer Causes Control. 1995 Jul;6(4):339–346. doi: 10.1007/BF00051409. [DOI] [PubMed] [Google Scholar]
  4. Correa P., Haenszel W., Cuello C., Tannenbaum S., Archer M. A model for gastric cancer epidemiology. Lancet. 1975 Jul 12;2(7924):58–60. doi: 10.1016/s0140-6736(75)90498-5. [DOI] [PubMed] [Google Scholar]
  5. Craanen M. E., Dekker W., Blok P., Ferwerda J., Tytgat G. N. Time trends in gastric carcinoma: changing patterns of type and location. Am J Gastroenterol. 1992 May;87(5):572–579. [PubMed] [Google Scholar]
  6. Dubrow R., Bernstein J., Holford T. R. Age-period-cohort modelling of large-bowel-cancer incidence by anatomic sub-site and sex in Connecticut. Int J Cancer. 1993 Apr 1;53(6):907–913. doi: 10.1002/ijc.2910530607. [DOI] [PubMed] [Google Scholar]
  7. Dubrow R., Johansen C., Skov T., Holford T. R. Age-period-cohort modelling of large-bowel-cancer incidence by anatomic sub-site and sex in Denmark. Int J Cancer. 1994 Aug 1;58(3):324–329. doi: 10.1002/ijc.2910580303. [DOI] [PubMed] [Google Scholar]
  8. Geddes M., Balzi D., Tomatis L. Progress in the fight against cancer in EC countries: changes in mortality rates, 1970-90. Eur J Cancer Prev. 1994 Jan;3(1):31–44. doi: 10.1097/00008469-199401000-00005. [DOI] [PubMed] [Google Scholar]
  9. Hansson L. E., Bergström R., Sparén P., Adami H. O. The decline in the incidence of stomach cancer in Sweden 1960-1984: a birth cohort phenomenon. Int J Cancer. 1991 Feb 20;47(4):499–503. doi: 10.1002/ijc.2910470405. [DOI] [PubMed] [Google Scholar]
  10. Holford T. R. Analysing the temporal effects of age, period and cohort. Stat Methods Med Res. 1992;1(3):317–337. doi: 10.1177/096228029200100306. [DOI] [PubMed] [Google Scholar]
  11. Holford T. R. Understanding the effects of age, period, and cohort on incidence and mortality rates. Annu Rev Public Health. 1991;12:425–457. doi: 10.1146/annurev.pu.12.050191.002233. [DOI] [PubMed] [Google Scholar]
  12. Howson C. P., Hiyama T., Wynder E. L. The decline in gastric cancer: epidemiology of an unplanned triumph. Epidemiol Rev. 1986;8:1–27. doi: 10.1093/oxfordjournals.epirev.a036288. [DOI] [PubMed] [Google Scholar]
  13. Jensen O. M., Estève J., Møller H., Renard H. Cancer in the European Community and its member states. Eur J Cancer. 1990;26(11-12):1167–1256. doi: 10.1016/0277-5379(90)90278-2. [DOI] [PubMed] [Google Scholar]
  14. Laurén P. A., Nevalainen T. J. Epidemiology of intestinal and diffuse types of gastric carcinoma. A time-trend study in Finland with comparison between studies from high- and low-risk areas. Cancer. 1993 May 15;71(10):2926–2933. doi: 10.1002/1097-0142(19930515)71:10<2926::aid-cncr2820711007>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]
  15. Osmond C., Gardner M. J. Age, period and cohort models applied to cancer mortality rates. Stat Med. 1982 Jul-Sep;1(3):245–259. doi: 10.1002/sim.4780010306. [DOI] [PubMed] [Google Scholar]
  16. Parkin D. M., Lärä E., Muir C. S. Estimates of the worldwide frequency of sixteen major cancers in 1980. Int J Cancer. 1988 Feb 15;41(2):184–197. doi: 10.1002/ijc.2910410205. [DOI] [PubMed] [Google Scholar]
  17. Taylor D. N., Blaser M. J. The epidemiology of Helicobacter pylori infection. Epidemiol Rev. 1991;13:42–59. doi: 10.1093/oxfordjournals.epirev.a036078. [DOI] [PubMed] [Google Scholar]
  18. Zheng T., Mayne S. T., Holford T. R., Boyle P., Liu W., Chen Y., Mador M., Flannery J. The time trend and age-period-cohort effects on incidence of adenocarcinoma of the stomach in Connecticut from 1955-1989. Cancer. 1993 Jul 15;72(2):330–340. doi: 10.1002/1097-0142(19930715)72:2<330::aid-cncr2820720205>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]

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