An Epidemiological Study of Gastric Cancer in the Adult Population Referred to Gastroenterology Medical Services in Romania – a Multicentric Study
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Daniela Dobru1, Oliviu Pascu2, Marcel Tantau2, Cristian Gheorghe3, Adrian Goldis4, Gheorghe Balan5, Felicia Coman6, Alexandru Fraticiu7, Eugen Dumitru8, Eftimie Miutescu9, Adrian Saftoiu10, Vladimir Bacarea11

1) Gastroenterology Department, University of Medicine and Pharmacy Tg. Mures. 2) 3rd Medical Clinic, University of Medicine and Pharmacy Cluj Napoca. 3) Gastroenterology and Hepatology Center, Fundeni Clinical Institute, Bucharest. 4) Gastroenterology Clinic, University of Medicine and Pharmacy Timisoara. 5) Gastroenterology and Hepatology Institute Iasi. 6) Gastroenterology Department, District Hospital Brasov. 7) Gastroenterology Department, District Hospital Sibiu. 8) 1st Medical Clinic Constanta. 9) Gastroenterology Department, District Hospital Arad. 10) Gastroenterology Department, University of Medicine and Pharmacy Craiova. 11) Epidemiology Department, University of Medicine and Pharmacy Tg.Mures

Abstract

Aim. The Romanian Society of Digestive Endoscopy proposed a multicentric study to evaluate the prevalence of gastric cancer in the adult population referred to gastroenterology medical services, and also the demographic features of this pathology.

Methods. The study was carried out over the period 1 January 2003 – 31 December 2003 in 11 academic centers in Romania, specialized in gastroenterology, with a uniform national distribution (all areas in the country were represented) and with adequate diagnostic and therapeutic facilities. All centers used identical definition criteria and reported the data using the same protocol and a Microsoft Excel database.

Results. During the study period, 640 cases of gastric cancer were reported. In the first stage, the prevalence in each geographical region was calculated. The national prevalence of gastric cancer in the population referred to gastro-intestinal endoscopy services was 2.9 per 100,000 inhabitants over 18 years of age. The demographic data of the studied group were the following: 66.4% men, 33.6% women, 51.7% urban population, 48.3% rural population, mean age 63.07±12.10 years. The most frequent indications for upper digestive endoscopy were: dyspepsia, weight loss and appetite. 88% of patients had no history of disease with a high risk of gastric cancer. The majority of patients (95.5 %) had advanced gastric cancer at the time of diagnosis, located in the gastric body (40.1 %) and in the antrum (33.8 %). According to Borrmann’s classification, 31.4% had type I fungating gastric cancer and 32.1% had type III ulcero-infiltrative gastric cancer. According to the Lauren classification, the most frequent histological type was intestinal adenocarcinoma (63.8 %). Early gastric cancer was found in 4.4% of patients.

Conclusions. The prevalence of gastric cancer in the population referred to digestive endoscopy services in Romania is 2.9%, with relatively wide variations at a national level. The study confirms the fact that Romania is a country with a low prevalence of gastric cancer, in accordance with the literature data published for the south of Europe.

Key words

Gastric cancer - prevalence – pathology – Lauren’s classification – Borrmann’s classification - incipient gastric cancer