Gastric cancer incidence and mortality trends between 2007-2016 in three European countries.

Background/aims: Increased awareness of gastric cancer risk, easy access to upper endoscopy, high-definition endoscopes with virtual chromoendoscopy may have led to an increase in early gastric cancer diagnosis within the last years in Europe. Early diagnosis of gastric cancer may be associated with improved survival. Currently, no data exist on the impact of early diagnosis in gastric cancer patients’ survival at a population level in Europe. Our aim was to assess incidence, early diagnosis rate and gastric cancer survival both in North-Western and Southern European countries with a low to moderate GC incidence. Methods: Data on 41,138 gastric cancer cases between 2007 and 2016 were retrieved from national cancer registries of Belgium, the Netherlands and the Northern Region in Portugal (RORENO). Age standardized incidence and mortality rates (ASMR) were assessed and expressed by 100,000 persons. Early diagnosis was defined as T1 staged tumors (TNM staging). Net survival estimates for 2007-2011 vs 2012-2016 were determined and compared. Results: Age-standardized incidence and mortality decreased over time in Belgium, Northern Portugal and the Netherlands. Early gastric cancer diagnosis increased over time for all the countries. Net 1- year survival improved significantly between the two time periods in all countries and at 5 years in Belgium and Portugal. Conclusions: This is the first study comparing trends in gastric cancer incidence and mortality in some European countries. We found from 2007-2016 a trend towards a rising proportion of T1 gastric cancers and a decrease in ASMR over time, supporting the efforts in secondary prevention strategies.