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Thailand has low prevalence of gastric adenocarcinoma cancer
- Thread starter ginfreely
- Start date
Abstract
Background and aim:Thailand and Japan have high prevalence of Helicobacter pylori infection but prevalence of gastric cancer and mortality rate are difference. Most international comparative studies are epidemiologic studies and the difference in actual clinicopathological data has not been clarified. This study aimed to investigate the difference in clinicopathological characteristics of gastric adenocarcinoma between Thailand and Japan.Methods: This retrospective study was conducted in two high-volume hospitals for gastric cancer in Thailand and Japan. Baseline characteristics, clinical manifestations, tumor characteristics, treatments and mortality rate of gastric cancer patients in the two institutions were examined.
Results: A total of 403 Thai and 2,318 Japanese patients were retrieved from the electronic database. Finally, 332 Thai and 414 Japanese patients (randomly sampled) with gastric adenocarcinoma were eligible for analysis. Thai gastric adenocarcinoma patients were significantly younger than the Japanese (59 ± 13 vs. 68 ±10 years old, p<0.001) and the majority of Thai patients were female (55% vs. 25%, p<0.001). The rate of smoking (5.1% vs. 23%, p<0.001) and alcohol drinking (2.7% vs. 34%, p<0.001) were lower in Thai patients when compared with those in Japanese. The mortality rate at the conclusion of this study (July 2016) was significantly higher in Thai patients (75.3% vs. 7%, p<0.001). In multivariate analysis, ethnicity, clinical UICC stage II-IV compared to I, and resection-based treatment were significant prognostic factors after adjusting for age, gender, presence of alarm symptom, lesion extension and histology.
Conclusion: Thai patients with gastric adenocarcinoma were different from Japanese patients in all aspects. Advanced stage of disease, country, and un-resected tumor were associated with poor prognosis. An individual strategy to improve survival of gastric adenocarcinoma in a low-prevalence area such as Thailand should be explored.
Conclusion: Thai patients with gastric adenocarcinoma were different from Japanese patients in all aspects. Advanced stage of disease, country, and un-resected tumor were associated with poor prognosis. An individual strategy to improve survival of gastric adenocarcinoma in a low-prevalence area such as Thailand should be explored.
Introduction
Gastric adenocarcinoma remains a health-care problem all over the world due to its high mortality rate [1, 2]. Thailand has low prevalence of gastric adenocarcinoma; however, the mortality rate is high because patients usually present with advanced stage of disease [3]. In contrast, although there is a high prevalence of gastric adenocarcinoma in Japan, the mortality rate is low because of early diagnosis and prompt curative treatment by endoscopic and surgical resection [4]. In countries where gastric cancer screening is implemented i.e. Japan and Korea, mortality rate is about half of the incidence rate [5]. In contrast, mortality rate is very close to the incidence rate in other Asian countries, including Thailand [5]. Early gastric cancer detection strategy by endoscopy may contribute to better survival rate in those countries [6,8]. However, most international comparative studies were conducted based on epidemiological data [9] and studies to compare actual clinicopathological data have been lacking.According to the recommendation from National Cancer Institute (NCI), there was no evidence that gastric cancer screening program by endoscopy would increase survival rate in low prevalence area of gastric cancer [10]. Moreover, screening endoscopy in low incidence countries is not efficient and cost-effective because of the low detection rate of gastric cancer despite large numbers of screening endoscopy [10]. The differences in patient’s clinicopathological characteristic between high and low prevalence of gastric cancer region should be further examined to elucidate factors that associate with poor survival rate of patients with gastric cancer. Therefore, this study aimed to evaluate characteristics of patients with gastric adenocarcinoma and factors associated with different outcome in Thailand and Japan to find a clue to improve patients’ survival in low prevalence country such as Thailand.
Capsule endoscopy is a procedure that uses a tiny wireless camera to take pictures of the organs in the body that food and liquids travel through. This is called the digestive tract. A capsule endoscopy camera sits inside a vitamin-sized capsule. After it's swallowed, the capsule travels through the digestive tract.
And idk where got gastroscopy that cost $500 to $800. I know my private hospital one cost almost 4k. Thank goodness I got insurance.
Actually the cheapest is to do a blood test called Gastro clear to tell you got stomach cancer high risk or not that cost about $300 plus another $60 or more for consultation.
And if high risk got to do endoscopy to confirm got stomach cancer or not so everything goes back to endoscopy.
Seriously if a simple blood test in spore for stomach cancer cost $300 plus, how can gastroscopy be costing $500 to $800?
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